Abstract C059: Disparities in area-level socioeconomic status and head and neck cancer specific quality of life

Abstract Introduction: Socioeconomic status may influence quality of life (QoL) in patients with head and neck cancer (HNC). Patients from socioeconomically disadvantaged areas often face systemic barriers and resource limitations that can negatively impact cancer-related QoL even prior to treatment. However, the impact of socioeconomic status on HNC QoL has not been explored. Thus, the purpose of this study was to evaluate the association between state-level ADI and pre-treatment head and neck (HN) specific symptoms and issues in patients with HNC. Methods: This is a retrospective cohort study of patients undergoing treatment for HNC between November 2015 and September 2022. The Functional Assessment of Cancer Therapy–Head and Neck (FACT-HN) Version 4 was administered to patients as part of routine pretreatment evaluation with psych-oncology prior undergoing treatment for HNC. The outcome variable, HNC-specific symptoms and issues (e.g., ability to eat, dry mouth, cough, difficulty swallowing), was measured using 12 HNC-specific items within the FACT-HN. The exposure variable, socioeconomic status (SES), was measured by the Area Deprivation Index (ADI; a composite socioeconomic status score which includes indices of education, occupation, household income, housing, poverty level, and access to utilities). ADI data was categorized into quintiles with the lowest quintile representing higher SES and higher quintile representing lower SES. Kruskal-Wallis tests were used to examine the association between ADI and HNC specific symptoms and issues. Results: A total of 600 patients were included in the study of whom 18.3% resided in areas in the first quintile, 19.8% in second quintile, 19.8% in third quintile, 19.7% in fourth quintile, and 22.3% in fifth quintile. Patients who resided in more deprived areas (areas with higher deprivation) reported lower ability to eat foods they like (P=0.043), eat as much food as they want (P=0.006), swallow naturally and easily (P=0.001), and eat solid foods (P=0.003). Additionally, tobacco use was more frequent in patients who resided in higher deprivation areas (P=0.003). Other items such as dry mouth, breathing difficulty, voice quality, appearance dissatisfaction, pain, communication ability, and alcohol use showed no statistically significant variation across quintiles. Conclusions: Higher levels of socioeconomic deprivation are associated with lower baseline QoL in patients with HNC, particularly in domains related to eating and swallowing function. These findings highlight the need to consider social determinants of health in supportive care and clinical management strategies. Citation Format: Mrudula Nair, Samantha Tam, Amy M. Williams, Kylie S. Springer, Ranjani Balakrishnan, Kyle Leonard, Kimberly A. Oslin, Veronica Bernacchi, Eric Adjei Boakye. Disparities in area-level socioeconomic status and head and neck cancer specific quality of life [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr C059.