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Head & Neck

(34) Does Economic Status Influence Oral Squamous Cell Carcinoma?

Thursday, September 18, 2025
2:30 PM - 4:00 PM EDT
Disclosure(s):
David Vaughan, DDS, MD: No financial relationships to disclose
Abstract:

Background: Late diagnosis of oral squamous cell carcinoma (OSCC) adversely impacts survival rates. Socioeconomic status (SES) may contribute to the delay in diagnosing several conditions, including OSCC.

Purpose: The purpose of this study was to answer the following research question: In subjects presenting with OSCC, do subjects with low SES, compared to higher SES, present with an advanced clinical stage at the time of diagnosis?
Study Design, Setting, and Sample This is a retrospective cohort study of 104 patients with OSCC who presented at Louisiana State University Health Sciences Center in New Orleans, Louisiana, between 2016 and 2022. Inclusion criteria were ≥ 18 years and completed treatment. Exclusion criteria were < 18 years, different types of cancer, and did not complete treatment.
Predictor Variable: The primary predictor variable was SES (high versus low), measured by Distress Community Index (DCI).
Main Outcome Variable: The primary outcome was clinical stage at time of diagnosis (early vs advanced). Secondary outcomes included pathological stage following surgery, treatment type, LOS in days, and recurrence.
Covariates: Covariates recorded were age, sex, race, American Society of Anesthesiologists physical status (ASA) classification, and OSCC sites.
Analyses: Descriptive and bivariate analyses were performed. Pearson’s chi-square or Fisher’s exact tests were used for categorical variables. Mann-Whitney U test was used for continuous variables. Multiple logistic regression was used to study the association between a binary outcome and covariates of interest. Statistical significance was P < .05.

Results: A cohort of 104 patients were included. There were 63 (61%) subjects (36 males), ages 64.9 ± 12.7 years in high SES group and 41 (39%) subjects (25 males) ages 66.3 ± 12.7 years in low SES group. Analyzing the clinical stage at time of diagnosis and SES showed no clinical significance. After adjusting covariates, there was a significant correlation between clinical stage at time of diagnosis and older patients (1.11, 1.02 to 1.22, 0.02), multi-modality treatment (22.78, 3.16 to 163.97, 0.002) and longer LOS (1.49, 1.11 to 2.01, 0.008).
Conclusion and Relevance: OSCC patients are typically older at diagnosis, need multimodality treatment, and have longer LOS.