Multilevel Associations of Food Environment with Tongue Carcinoma Prognosis in the United States

Tuesday, October 20, 2026

7:42 AM - 7:48 AM PT

Location: 406A

Presenting Author(s)

AH

Ali A. Haider

Medical Student
University of Tennessee Health Science Center
Memphis, TN, United States

Co-Author(s)

AH

Ali A. Haider

Medical Student
University of Tennessee Health Science Center
Memphis, TN, United States
David J. Fei-Zhang, MD, MBA

Resident Physician
Northwestern University Program
Chicago, Illinois, United States
JD

Jill N. D'Souza, MD

Associate Professor
Louisiana State University Health Sciences Center
NEW ORLEANS, LA, United States
Jeffrey C. Rastatter, MD, MS

Professor
Ann and Robert H Lurie Children's Hospital of Chicago
Chicago, Illinois, United States
Daniel C. Chelius, Jr., MD

Associate Professor
Baylor College of Medicine/Texas Children's Hospital
Houston, Texas, United States

Senior Author(s)

AS

Anthony M. Sheyn, MD, FACS

Professor
University of Tennessee Health Science Center, Department of Otolaryngology, Head & Neck Surgery
Memphis, Tennessee, United States

Introduction: For tongue carcinoma (TC) patients, prior investigations have characterized how social influencers of health (SIoH) pertaining to individuals and their community affect their diagnosis and survival but remain limited to traditionally known SIoH-factors. With rising inquiry among aerodigestive cancers regarding the effects of nutritional access, we used the Food Environment Atlas (FEA) to assess how the food environment affects TC-prognostic outcomes in the US while adjusting for prior-known factors

Methods: Retrospective cohort analysis of 47,297 TC-patients diagnosed from 2000-2017 within the NCI-SEER dataset who were matched to county-level scores from the USDA-FEA, a large-data, area-based index spanning 280+ food environment factors. Associations of independent variables comprising increasing FEA-scores/food environment vulnerability were analyzed via race-stratified, multivariable Cox-Hazards and logistic regression models for outcomes of overall, 1-, 3-, and 5-year mortality, alongside advanced staging at first diagnosis

Results: Higher FEA scores were associated with increased overall mortality (HR 1.02, 95%CI 1.01, 1.04), with exacerbated effects among non-White patients (1.08, 1.06-1.10) but not (non-Hispanic) White patients. Similar overall trends were observed with increased 3-year (OR 1.02, 95%CI 1.01-1.04) and 5-year mortality (1.02, 1.01-1.04), alongside advanced staging (1.02, 1.01-1.04), which were exacerbated solely among non-White patients (3-year: 1.10, 1.07-1.14; 5-year: 1.13, 1.09-1.17; Staging: 1.11, 1.08-1.15)

Conclusions: TC-patients showed detrimental associations in survival and staging with increasing food environment vulnerability, especially among non-White patients. Using multilevel approaches, this study unveiled nuanced interactions of individual- and county-level SIoH-factors that may influence nutritional-based TC-disparities, which can shift public health advocacy towards overlooked vulnerabilities