Abstract B124: Neighborhood socioeconomic deprivation, race, and head and neck squamous cell carcinoma survival

Abstract

Head and neck squamous cell carcinoma (HNSCC) demonstrates striking survival disparities by race, with non-White patients experiencing poorer outcomes. There are growing data for a role of neighborhood socioeconomic deprivation in HNSCC disparities, but there has been little study of potential interactions between race and neighborhood deprivation and their joint contributions to HNSCC survival. We leveraged data from a cohort of HNSCC patients at the University of Maryland Medical Center (UMMC, n=1,640). Patients were diagnosed from 2016-2025. Multivariable-adjusted Cox models were used to compute hazard ratios (HR) and 95% confidence intervals (95% CI) for HNSCC survival in relation to race and neighborhood socioeconomic deprivation based on the Area Deprivation Index (ADI), adjusting for various potential confounders such as sex, age, smoking, and tumor stage. ADI was analyzed as a continuous variable initially, but was dichotomized into low (1-60) and high (61-100) deprivation categories for assessment of potential interactions with race. The p-value for interaction was determined based on a type III global test for interaction between race and the two-level ADI variable in the multivariable-adjusted model. We also assessed the joint effect between different race groups and high ADI (compared to the White, low ADI group) with regard to survival. In this cohort, 79% of patients self-identified as White, 16% as Black, 3% as Asian, and 2% as other race groups. Compared to White patients, Black and Asian patients tended to have worse survival for oral cavity cancer, but not other HNSCC subtypes. Higher ADI was associated with worse overall survival across the cohort. Racial disparities were attenuated in the high-ADI neighborhoods, but persisted in the lower ADI areas (p-interaction = 0.08). Evaluating joint effects of race and high ADI, compared to low-ADI White patients, high-ADI Black patients experienced significantly worse overall survival (HR =1.75, CI = 1.09-2.62), but there was no significant effect for high-ADI Asian patients. We identified an interaction between race and ADI with regard to HNSCC survival, such that that racial disparities were most pronounced in areas with lower deprivation. More research is needed to investigate drivers of these associations. Raquel Rowell, Madeleine Ndahayo, Ranee Mehra, Daria Gaykalova, Kathryn H. Barry. Neighborhood socioeconomic deprivation, race, and head and neck squamous cell carcinoma survival [abstract]. In: Proceedings of the 19th AACR Conference on the Science of Cancer Health Disparities; 2026 Oct 18-21; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2026;35(10 Suppl):Abstract nr B124.