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Volume 2: No. 2, April 2005
SPECIAL TOPICS
ORIGINAL RESEARCH: FEATURED
ABSTRACT FROM THE 19TH NATIONAL CONFERENCE ON CHRONIC DISEASE
PREVENTION AND CONTROL
Racial Differences in Factors That Influence Survival With
Oral Cancer in Georgia: 1978–2001
Ranjitha Krishna, Jonathan Liff, Amy Chen, Paul Eke, Valerie Robison
Suggested citation for this article: Krishna R, Liff J,
Chen A, Eke P, Robison V. Racial differences in factors that
influence survival with oral cancer in Georgia: 1978–2001
[abstract]. Prev Chronic Dis [serial online] 2005 Apr [date cited]. Available from:
URL: http://www.cdc.gov/pcd/issues/2005/
apr/04_0142i.htm.
PEER REVIEWED
Track: Health System Change
The purpose of this study was to examine the racial
differences in distribution of risk factors associated with oral
cancer survival in Georgia (1978–2001).
Studies have shown that the five-year survival rate for people
with oral cancers is much lower in blacks than whites. According
to the Surveillance, Epidemiology and End Results (SEER) program,
the national five-year survival rate for people with cancers of
the oral cavity and pharynx from 1992 to 1997 was 36.1% for
blacks and 59.7% for whites.
Data from 1503 whites and 531 blacks with oral cancers in five urban and 10
rural counties of Georgia from 1978 to 2001 were analyzed. Data were collected
by the Georgia Center for Cancer Statistics, a population-based cancer registry affiliated
with the SEER program. Racial disparities were examined in stage
at diagnosis, grade of cancer, sex, age, socioeconomic status,
rural/urban residence, and type of treatment.
Compared with whites, blacks were twice as likely (Odds Ratio [OR] = 2.5,
95% Confidence Interval [CI], 2.0–3.0) to die during the five-year follow-up time.
Compared with whites older than 70 years, blacks were 2.2 times
(95% CI, 1.6–3.1) more likely to be diagnosed at age 61 to 70 years, 3.7 times (95% CI, 2.7–5.1) more likely to be diagnosed at
age 51 to 60 years, and 4.8 times (95% CI, 3.4–6.7) more likely
to be diagnosed at younger than 50 years. Compared with whites
who were mostly diagnosed at the localized stage of the disease,
blacks were 3.0 times (95% CI, 2.4–3.8) more likely to be
diagnosed at the regional stage and 4.8 times (95% CI, 3.4–6.7)
more likely to be diagnosed after distant metastasis. Blacks were
also more likely to have grade 2 (OR 3.0; 95% CI, 2.3–3.9) and
grade 3 (OR 2.2; 95% CI, 1.6–3.1) cancers. Consequently, blacks
were 95% more likely than whites to have received radiation (OR 3.1; CI,
2.2–4.3) or both radiation and surgery (OR 2.3; 95% CI,
1.7–2.9). Whites were more likely than blacks to have received surgery
only.
In Georgia, diagnoses of oral cancers in black patients
occurred at a much younger age and at a more advanced stage and
higher grade of disease. Oral cancers in black patients were also
treated with other than cancer-directed surgery only. These
disparities highlight both a challenge to further understand the
reasons for racial disparities in survival rates of patients with
oral cancers and an opportunity to reduce those disparities.
Corresponding Author: Ranjitha Krishna, BDS, MPH, Guest
Researcher, Centers for Disease Control and Prevention, National
Center for Chronic Disease Prevention and Health Promotion,
Division of Oral Health, 4770 Buford Hwy NE, Mail Stop F-10,
Atlanta, GA 30341. Telephone: 770-488-3075. E-mail: rkrishna@cdc.gov.
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