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Geographic and Socioeconomic Landscape of Veterans With Head and Neck Cancer.

Zayan KL, McCoy JL, Boudreaux-Kelly MY, Brenner C, Hahn Z, Zevallos JP, Spector ME, Hotchkiss J, Maxwell JH. Geographic and Socioeconomic Landscape of Veterans With Head and Neck Cancer. Head & neck. 2025 Oct 1; 47(10):2845-2855, DOI: 10.1002/hed.28209.

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Abstract:

BACKGROUND: US Veterans experience higher rates and worse outcomes for head and neck squamous cell carcinoma (HNSCC) compared to civilians. Geographic and socioeconomic barriers remain unclear. METHODS: This retrospective descriptive study analyzed VA data nationwide (2012-2022), identifying Veterans with HNSCC using ICD codes. Subsites included oral cavity, oropharynx (OPC), hypopharynx, larynx, and nasopharynx. Rurality, deprivation, and travel distances were assessed. RESULTS: Among 75,453 Veterans with HNSCC, 36% lived in rural areas, with travel times of 94 min to tertiary VA facilities. Approximately 32% had high deprivation (area deprivation indices [ADI] 75). OPC cases increased from 26.3% in 2012 to 46% in 2022, while laryngeal cancers declined. OPC patients were less deprived (p < 0.001) but had similar travel distances and rurality compared to non-OPC patients. CONCLUSION: Overall, Veterans experience high deprivation, long travel times, and over one-third live in rural communities, highlighting potential barriers to access and equity among Veterans with HNSCC.




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