Researchers at Fox Chase Cancer Center found that disparities in the incidence of head and neck cancer are driven by behavioral and environmental risk factors rather than race.
They demonstrated this in the first-ever study to compare HNC incidence in Black patients in the United States, the Caribbean, and Africa.
The paper, “Heterogeneity in Head and Neck Cancer Incidence Among Black Populations from Africa, the Caribbean and the USA: Analysis of Cancer Registry Data by the AC3,” was published in Cancer Epidemiology.
Existing research shows that in the United States, Blacks have a higher incidence of HNC overall and in tobacco- and alcohol-related subsites than whites, suggesting that race may be a factor in the incidence of HNC.
However, in the recently published study led by Camille Ragin, a professor in the Cancer Prevention and Control research program at Fox Chase, researchers found that the HNC subsites and their associated risk factors showed significant variation by geography and region.
“It tells us that a lot of the disparities in incidence that we see for head and neck cancer are being driven primarily by behavior and these risk factors, not necessarily because of Black race,” Ragin said in a statement.
The study was conducted by the HNC working group of the African Caribbean Cancer Consortium (AC3), a global effort to assess cancer burden in the African diaspora, which Ragin founded in 2006. Researchers compiled cancer registry data from the Caribbean, Africa, and the United States, collecting and analyzing nearly 15,000 cases of HNC that occurred between 2013 and 2015.
The first author of the study was Aviane Auguste, an early stage investigator at the University Hospital of Guadeloupe. Auguste is a mentee of the AC3 Mentor-Mentee Matching Program, which was founded as part of an NCI-P20 grant awarded to Fox Chase. The program is a partnership between Fox Chase and the University of the West Indies.
The researchers found that the incidence trends in HNC subsites in the United States did not hold true across Black populations in other regions. Certain risk factors for HNC, such as HPV infection and tobacco and alcohol abuse, may be specific to certain geographic regions since incidence rates of HNC in HPV-related subsites were higher in some Caribbean and African countries, while incidence rates of HNC in alcohol- and tobacco-related subsites were higher in others.
These findings may help inform public health administrators’ behavioral intervention efforts, such as where smoking cessation programs would be more effective versus HPV vaccination.
