Disparities in Stage at Diagnosis among Adults with Oral Cancer

OBJECTIVE: To explore the distribution of stage at diagnosis among Kentucky adults with oral cancer in relation to race. METHODS: We obtained 2000-2004 oral cancer incidence data from the Kentucky Cancer Registry and the 1999-2003 oral cancer incidence data from the Surveillance, Epidemiology, and End Results (SEER) Program. The proportion for each oral cavity site by stage at diagnosis in relation with race, smoking and insurance status was computed. Multivariate analysis (logistic regression) was used to determine the relationship between race and stage at diagnosis while controlling for age, gender, smoking and insurance status. RESULTS: A total of 1465 cases of oral cavity cancer were reported to the Kentucky Cancer Registry between 2000 and 2004. Compared to Caucasians, African Americans had a significantly higher proportion of oral cancer, mainly in the gums and tongue, that had spread to a regional lymph nodes or to a distant site at diagnosis. (OR= 1.6; 95% CI 3.3, 0.97). CONCLUSION: Among adults with oral cancer reported to the Kentucky Cancer Registry from 2000-2004, African Americans were diagnosed with more advanced disease compared to Caucasians. One possible explanation may be a difference in access to, and utilization of, health care services.