Abstract A111: Language isolation and head and neck cancer incidence among Hispanic populations in the United States

Abstract Background: Effective communication between patients and healthcare providers is essential for high-quality cancer care, especially in prevention and early detection. Individuals with limited English proficiency often face language barriers that limit access to preventative services and timely diagnosis. While most research has examined individual-level language barriers, less is known about county-level language isolation, a community-level factor that may reflect broader challenges of linguistic access and acculturation. These factors may shape cancer-related beliefs, behaviors, and healthcare utilization that may impact incidence of head and neck cancer (HNC), especially in minority communities. Although Hispanic populations tend to have lower HNC incidence than non-Hispanic white patients, the impact of county-level language isolation on HNC incidence and stage at diagnosis across these groups remains unclear. Methods: We conducted a cross-sectional study using SEER cancer incidence data (2000–2021) linked with U.S. Census county-level data. Key independent variables included county-level language isolation (the percentage of households where no one aged 14+ speaks English well) and the percentage of foreign-born residents. The primary outcome was HNC incidence, including cancers of the oral cavity, pharynx, and larynx as well as stage at diagnosis categorized as early (localized/regional) or advanced (distant) stage. Counties were grouped into quintiles by language isolation (Q1 = lowest, Q5 = highest). Age-adjusted incidence rates per 100,000 were calculated using SEER*Stat v8.4.5, with 95% confidence intervals estimated via the Tiwari method. Results: Our analysis included 738 million Hispanic and 2.3 billion non-Hispanic individuals, among whom 44,330 and 439,209 HNC cases were identified, respectively. Non-Hispanic individuals had higher rates of both early- and advanced-stage HNC across most county-level language isolation quintiles. However, in the lowest isolation quintile (Q1), Hispanic individuals had a higher incidence of advanced-stage HNC than non-Hispanic individuals. A statistically significant inverse relationship was observed between language isolation and HNC incidence with counties with higher language isolation had significantly lower age-adjusted incidence rates for both Hispanic (Q1: 14.1 [95% CI: 11.3–17.3] vs. Q5: 9.4 [95% CI: 9.3–9.5], p<0.0000) and non-Hispanic populations (Q1: 18.5 [95% CI: 18.2–18.8] vs. Q5: 14.6 [95% CI: 14.6–14.7], p<0.0004). Similar trends were observed when stratified by foreign-born status. Conclusion: Higher county-level language isolation is associated with lower HNC incidence among both Hispanic and non-Hispanic populations. This may reflect protective community factors or underdiagnosis in linguistically isolated areas. Acculturation linked to higher English proficiency may contribute to lifestyle changes that increase risk of HNC. Further research is needed to understand these patterns and inform culturally and linguistically appropriate interventions to reduce disparities. Citation Format: Rebecca A. Zasloff, Jason Semprini, Rosh Sethi, Nosayaba Osazuwa-Peters. Language isolation and head and neck cancer incidence among Hispanic populations in the United States [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 A111.