Women With Head and Neck Cancer Receive Less Treatment and Have Inferior Outcomes Compared With Men

An analysis from the Kaiser Permanente Northern California cancer registry showed that women with head and neck cancer are less likely to receive intensive chemotherapy and have an inferior outcome compared with men.  

These data were reported at the 2018 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago, Illinois.¹

The researchers set out using a mathematical model to stratify patients according to their relative hazard for death from cancer compared with death from other causes.

They used this model to evaluate outcomes for patients with head and neck cancer based on demographics and comorbidities.

They identified 884 cases of head and neck cancer diagnosis from the Kaiser Permanente Northern California database.

At diagnosis, patients were between 18 and 85 years old and had disease ranging from stage II to IVB.

The median follow up was 2.9 years; 271 patients died of cancer causes and 93 died of other causes.

Variables such as age, gender, tumor stage, Charlson Comorbidity Index, and history of smoking and alcohol use were factored into logistic regression models to calculate the odds of receiving intensive cancer treatment.

The model showed that women with head and neck cancer were less likely to receive intensive chemotherapy (35% vs 46% for men; P = .006) and radiation (60% vs 70% for men; P = .008) compared with men.

When variables such as age and serious medical conditions were accounted for cancer versus non-cancer mortality was two times higher for women compared with men. The ratio of cancer versus non-cancer deaths was 1.92 times higher for women than it was for men.

“We weren’t looking for gender differences, so the results were really surprising. Besides undertreatment, there are a number of factors that could contribute to the differences in outcomes between women and men with head and neck cancer, and it’s clear we need further investigation,” said senior study author Jed A. Katzel, MD, a medical oncologist at Kaiser Permanente in Santa Clara, California.

“With this mathematical model, we have a tool that can help us identify patients likely to benefit from more intensive treatment, as well as those more likely to die from other non-cancer related causes. The hope is that by integrating this model into our care, we can improve the care of all patients with head and neck cancer,” he added.

“We don’t know why women are getting less treatment and having worse outcomes, and we need to find out. Though these findings are specific to California, the disparities we see are startling and worth considering in treatment discussions in everyday practice,” said ASCO Expert Joshua A. Jones, MD, MA, in an ASCO press release.²

Read more of Cancer Therapy Advisor‘s coverage of the American Society of Clinical Oncology (ASCO) 2018 meeting by visiting the conference page.

Reference

1. Park A, Albaster A, Shen H, et al. Are women with head and neck cancer undertreated?  J Clin Oncol. 2018: 36, (suppl; abstr LBA6002). Presented at 2018 ASCO Annual Meeting; June 1-5, 2018; Chicago, IL.
2. American  Society of Clinical Oncology. Study Finds Gender Disparities in Head and Neck Cancer Treatment and Outcomes [press release]. June 1, 2018.