{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T19:28:27Z","timestamp":1783020507753,"version":"3.54.6"},"reference-count":47,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate how patient circumstances that may influence access to care, including area deprivation index (ADI), distance to care center, and rural\/urban status affect stage of presentation for HNSCC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Retrospective, single\u2010institution study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Urban, academic tertiary care center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with a history of HNSCC of the oral cavity, oropharynx, hypopharynx, larynx who presented to our institution between 2018 and 2023 were included. Demographic factors including age, race, sex, ADI, insurance status, distance to tertiary care center, and rural\u2010urban continuum codes were collected. Primary outcome of interest was clinical stage at presentation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>1170 patients met inclusion criteria, of which 675 (57.7%) presented with early\u2010stage disease and 495 (42.3%) presented with late\u2010stage disease. On multivariable analysis, closer proximity to care center, insurance status, current or former smoking status, p16 negativity, and tumor subsite of the oral cavity or hypopharynx were associated with late\u2010stage diagnosis. After sub\u2010stratification for patients within the closest distance quartile, female sex, p16 negativity, non\u2010white and non\u2010black race, and insurance status remained associated with late\u2010stage disease presentation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patient characteristics often associated with socioeconomic disadvantage including minority race, Medicaid, or lack of insurance were associated with a later stage of presentation for HNSCC. Individuals living within the closest distance to our tertiary care center were more likely to present with late\u2010stage disease, highlighting the need for improved access to care for socioeconomically disadvantaged urban populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ohn.70261","type":"journal-article","created":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T12:25:26Z","timestamp":1779452726000},"page":"156-164","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Socioeconomic Disadvantage and Care Proximity Influence Stage at Presentation in Head and Neck Cancer"],"prefix":"10.1002","volume":"175","author":[{"given":"Kelly","family":"Bridgham","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Sidney Kimmel Medical College\/Sidney Kimmel Comprehensive Cancer Center Thomas Jefferson University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Praneet","family":"Kaki","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Sidney Kimmel Medical College\/Sidney Kimmel Comprehensive Cancer Center Thomas Jefferson University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryce","family":"Hambach","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Sidney Kimmel Medical College\/Sidney Kimmel Comprehensive Cancer Center Thomas Jefferson University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annie","family":"Moroco","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Sidney Kimmel Medical College\/Sidney Kimmel Comprehensive Cancer Center Thomas Jefferson University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Mastrolonardo","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Sidney Kimmel Medical College\/Sidney Kimmel Comprehensive Cancer Center Thomas Jefferson University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meghan","family":"Crippen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Sidney Kimmel Medical College\/Sidney Kimmel Comprehensive Cancer Center Thomas Jefferson University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Cognetti","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Sidney Kimmel Medical College\/Sidney Kimmel Comprehensive Cancer Center Thomas Jefferson University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arielle","family":"Thal","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Sidney Kimmel Medical College\/Sidney Kimmel Comprehensive Cancer Center Thomas Jefferson University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,22]]},"reference":[{"issue":"2","key":"e_1_2_8_2_1","article-title":"Epidemiology, risk factors, and prevention of head and neck squamous cell carcinoma","volume":"11","author":"Barsouk A","year":"2023","journal-title":"Med Sci"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.128.11.1282"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-07-2774"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijd.14026"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2024.42.16_suppl.4572"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2018.00536"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2018.12.023"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0149886"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2407-9-364"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2016-209013"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13304-019-00632-5"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1023\/A:1026321923883"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11524-006-9094-x"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.7326\/M19-1510"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1802313"},{"key":"e_1_2_8_17_1","unstructured":"AdamoMDL RuhlJ.SEER Program Coding and Staging Manual 2018. 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