{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:37:30Z","timestamp":1783039050592,"version":"3.54.6"},"reference-count":21,"publisher":"Wiley","issue":"15","license":[{"start":{"date-parts":[[2021,4,2]],"date-time":"2021-04-02T00:00:00Z","timestamp":1617321600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Black patients with laryngeal squamous cell carcinoma (LSCC) historically have inferior outcomes in comparison with White patients. The authors investigated these racial disparities within the Veterans Health Administration (VHA), an equal\u2010access system, and within the Surveillance, Epidemiology, and End Results (SEER) program, which is representative of the US hybrid\u2010payer system.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with invasive (T1 or greater) LSCC were included from SEER (2004\u20102015) and the VHA (2000\u20102017). The primary outcomes of overall survival (OS) and larynx cancer\u2013specific survival (LCS) were evaluated in Cox and Fine\u2010Gray models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the SEER cohort (7122 patients: 82.6% White and 17.4% Black), Black patients were more likely to present with advanced disease and had inferior OS (hazard ratio [HR], 1.37; 95% CI, 1.26\u20101.50; <jats:italic>P<\/jats:italic> &lt; .0001) in a multivariable analysis. Black LCS was worse in a univariable analysis (HR, 1.42; 95% CI, 1.27\u20101.58; <jats:italic>P<\/jats:italic> &lt; .0001), but this effect was attenuated by 83% when the authors controlled for the TNM category and was found to be insignificant in a multivariable analysis (HR, 1.05; 95% CI, 0.93\u20101.18; <jats:italic>P<\/jats:italic> = .42). In the VHA cohort (9248 patients: 79.7% White and 20.3% Black), the 2 racial cohorts presented with similar tumor characteristics and similar OS (HR, 0.95; 95% CI, 0.89\u20101.02; <jats:italic>P<\/jats:italic> = .14). Black LCS was similar in univariable (HR, 1.10; 95% CI, 1.00\u20101.22; <jats:italic>P<\/jats:italic> = .05) and multivariable analyses (HR, 1.02; 95% CI, 0.92\u20101.14; <jats:italic>P<\/jats:italic> = .67).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Black patients with LSCC had a tumor burden at diagnosis and survival outcomes comparable to those of White patients within the VHA; this was counter to what was observed in the SEER analysis and prior national trends. This study's findings point toward the notable role of health care access in contributing to racial health disparities in the realm of larynx cancer.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.33557","type":"journal-article","created":{"date-parts":[[2021,4,2]],"date-time":"2021-04-02T17:39:16Z","timestamp":1617385156000},"page":"2705-2713","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Association of race and health care system with disease stage and survival in veterans with larynx cancer"],"prefix":"10.1002","volume":"127","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9242-844X","authenticated-orcid":false,"given":"Rohith S.","family":"Voora","sequence":"first","affiliation":[{"name":"School of Medicine University of California San Diego San Diego California"},{"name":"Department of Surgery, Division of Otolaryngology\u2013Head and Neck Surgery University of California San Diego San Diego California"},{"name":"Veterans Affairs San Diego Healthcare System San Diego California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikhil V.","family":"Kotha","sequence":"additional","affiliation":[{"name":"School of Medicine University of California San Diego San Diego California"},{"name":"Veterans Affairs San Diego Healthcare System San Diego California"},{"name":"Department of Radiation Medicine and Applied Sciences University of California San Diego School of Medicine La Jolla California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhishek","family":"Kumar","sequence":"additional","affiliation":[{"name":"Veterans Affairs San Diego Healthcare System San Diego California"},{"name":"Department of Radiation Medicine and Applied Sciences University of California San Diego School of Medicine La Jolla California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edmund M.","family":"Qiao","sequence":"additional","affiliation":[{"name":"School of Medicine University of California San Diego San Diego California"},{"name":"Veterans Affairs San Diego Healthcare System San Diego California"},{"name":"Department of Radiation Medicine and Applied Sciences University of California San Diego School of Medicine La Jolla California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander S.","family":"Qian","sequence":"additional","affiliation":[{"name":"School of Medicine University of California San Diego San Diego California"},{"name":"Veterans Affairs San Diego Healthcare System San Diego California"},{"name":"Department of Radiation Medicine and Applied Sciences University of California San Diego School of Medicine La Jolla California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1149-9532","authenticated-orcid":false,"given":"Bharat A.","family":"Panuganti","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Otolaryngology\u2013Head and Neck Surgery University of California San Diego San Diego California"},{"name":"Moores Cancer Center La Jolla California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6158-7162","authenticated-orcid":false,"given":"Matthew P.","family":"Banegas","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Center for Health Research Portland Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip A.","family":"Weissbrod","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Otolaryngology\u2013Head and Neck Surgery University of California San Diego San Diego California"},{"name":"Moores Cancer Center La Jolla California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tyler F.","family":"Stewart","sequence":"additional","affiliation":[{"name":"Moores Cancer Center La Jolla California"},{"name":"Division of Hematology\u2010Oncology University of California San Diego San Diego California"},{"name":"Division of Blood and Marrow Transplantation University of California San Diego San Diego California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3197-9552","authenticated-orcid":false,"given":"Brent S.","family":"Rose","sequence":"additional","affiliation":[{"name":"Veterans Affairs San Diego Healthcare System San Diego California"},{"name":"Department of Radiation Medicine and Applied Sciences University of California San Diego School of Medicine La Jolla California"},{"name":"Moores Cancer Center La Jolla California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7885-4327","authenticated-orcid":false,"given":"Ryan 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