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Scientific Oral Presentation

Care Equity, Quality, and Safety

Socioeconomic Influences on the Perceptions and Decision-making of Head and Neck Cancer Patients

Sunday, October 18, 2026
11:48 AM - 11:54 AM PT
Location: 406A

    Presenting Author(s)

  • Charlyn N. Gomez, MD

    Resident Physician
    Medstar Georgetown University Hospital
    Silver Spring, MD, United States

    • Co-Author(s)

  • FS

    Faiez Saiyed, MD

    Physician
    University of Maryland School of Medicine
    Baltimore, Maryland, United States

  • JB

    Jessica P. Brown, PhD

    Associate Professor
    University of Maryland School of Medicine, United States

  • KM

    Kelly Moyer, MD

    Assistant Professor & Chief
    University of Maryland School of Medicine, United States

    • Senior Author(s)

  • Rodney J. Taylor, MD MSPH MBA

    Professor and Chair
    University of Maryland School of Medicine
    Baltimore, MD, United States

Disclosure(s):
Charlyn N. Gomez, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Rodney J. Taylor, MD MSPH MBA:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Social determinants of health (SDoH) influence patient perceptions, decision-making (DM), treatment adherence, and outcomes among head and neck cancer (HNC) patients; however, perceptions rooted in SDoH are poorly characterized. Expanding on prior qualitative focus group findings, we evaluated the association between SDoH, patient-reported perceptions and DM priorities.

Methods: A cross-sectional survey assessing socioeconomic factors, health behaviors, treatment perceptions, and DM was administered to post-treatment HNC patients presenting for follow-up. Analyses include chi-square or Fisher’s exact testing and multivariable logistic or ordinal logistic regression.

Results: Fifty-seven patients completed the survey. Most were male (n=35) and white (n=42), with nearly half insured by Medicare (n=27). Eighty percent had surgery, 66.7% received radiation, and 36.8% received chemotherapy. Middle-(OR21.2, p=0.025) and high-income (OR14.1, p=0.031) status were associated with higher odds of agreeing that treatment options were well understood. Cost concerns were higher for privately insured patients and lower among those with higher income and education. High-income patients reported that treatment duration (OR0.10, 95%CI 0.02–0.54) and transportation (OR0.13, 95%CI 0.02–0.73) had less influence on decision-making. Privately insured patients had higher odds (OR6.65, 95%CI 1.41-34.08) of placing greater weight on time away from work in decision-making compared with non-private insurance beneficiaries. Those with some college had lower odds (OR0.11, 95%CI 0.01–0.78) of highly rating physician recommendation as an important factor compared to patients with less education. Non-Black race was associated with higher odds of prioritizing personal opinions in decision-making (OR11.37, 95%CI 1.62–90.23).

Conclusions: Income, insurance status, education, and race were independently associated with meaningful differences in perceptions and DM priorities among HNC patients. This highlights the need for SDoH-informed patient-centered, equitable interventions for DM in HNC care.