Oral Cancer Prognostic Disparities among Black Individuals: A Scoping Review

The relationship between sociodemographic factors and the development of oral squamous cell carcinoma (OSCC), the most prevalent malignant neoplasm of the oral cavity, remains poorly understood. This scoping review aimed to explore the influence of sociodemographic determinants on the occurrence of OSCC, with a particular focus on disparities affecting Black individuals and the impact of such inequities on prognosis. This review was registered on the Open Science Framework and conducted in accordance with PRISMA guidelines. Five databases and gray literature were systematically searched. Eligible studies included adult patients diagnosed with OSCC and examined associations between sociodemographic factors, such as socioeconomic status (SES), education level, monthly income, and race and oral cancer outcomes. Data were synthesized descriptively. Sixty-nine studies from 13 countries, totaling 1,009,752 patients, were included. Among patients with reported SES, 71.6% were classified as having low SES. Educational levels were also notably low: 36.2% of patients were illiterate, and 42.6% had only elementary education. Most research originated from countries with high or very high Human Development Index (HDI). Black patients exhibited worse OSCC prognosis compared to White patients, with a five-year survival rate of 33.9% versus 52.9%, advanced-stages diagnosis in 64.9% versus 47%, and higher mortality rates of 68.8% versus 48.8%, respectively. This review highlights a significant relationship between adverse sociodemographic determinants and the occurrence of OSCC. Black individuals showed worse prognostic variables compared to White patients. Despite most included studies being conducted in high- or very-high-HDI countries, racial disparities in OSCC prognosis persisted, suggesting that national development levels do not mitigate these inequities.