Otolaryngol Head Neck Surg. 2026 Sep 11. doi: 10.1002/ohn.70430. Online ahead of print.
ABSTRACT
OBJECTIVE: To assess age-related differences of community, social vulnerability associations with care and prognosis among those with nasopharyngeal carcinomas.
STUDY DESIGN: Retrospective Cohort.
SETTINGS: United States.
METHODS: This retrospective cohort study on 12,480 NPC-patients from 1975 to 2017 linked with 15 county-level vulnerability measures encompassing socioeconomic status (SES), minority-language status (ML), household composition (HH), housing-transportation (HT), and a total/composite vulnerability themes were assessed via adjusted linear and logistic regression analyses stratified across age groups of 20 to 44 years (younger) and ≥45 years (older) for outcomes of survival, multimodal treatment, and advanced staging.
RESULTS: Increased total vulnerability was associated with 45% (78.3-43.1 months) reductions in survival period among younger ages but only 22% (50.8-39.9 months) decreases among older ones. Increased total vulnerability was associated with increased chemotherapy (OR 1.17; 95% CI 1.10-1.24) and decreased external beam radiotherapy (OR 0.78; 95% CI 0.71-0.85) among younger groups compared to similar but diminished differences in chemotherapy (1.07; 1.04-1.11) and external beam radiotherapy (0.87; 0.84-0.90) for older ones. Increasing total vulnerability also showed similarly increased advanced staging across ages (younger-1.09; 1.03-1.11; older-1.09, 1.06-1.13). By magnitude, HH and SES-vulnerabilities contributed to these trends over ML and HT.
CONCLUSIONS: Increasing social vulnerability was associated with detrimental survival and treatment NPC-trends, with younger patients experiencing substantially higher magnitude correlations compared to older adults. With these trends largely constituted by HH and SES-drivers, these results present actionable targets for prospective efforts tackling the growing concerns of early-onset NPC.
PMID:42726934 | DOI:10.1002/ohn.70430
