(A1118) Geographic Disparities in Sinonasal Malignancies: A Single Institution Experience

Introduction: Sinonasal malignancies (SNM) are rare tumors with significant morbidity; data describing the relationship between SNMs and geographic location, presentation, and outcomes is limited. Understanding disparities in SNM care can inform novel interventions to improve outcomes in resource-limited settings.

Methods: A retrospective review was conducted on 45 patients with SNMs treated at the University of Arizona from 2010-2018. Patients were stratified into urban (n=26), suburban (n=10), and rural (n=9). We analyzed patient demographics, tumor characteristics, and quality of life metrics using SNOT-22. Statistical significance was defined as p< 0.05.

Results: The mean age at presentation was 63.4±15.4 years. Over 70% of SNMs originated from one of the paranasal sinuses, with 44.4% identified as squamous cell carcinoma (Urban 50%, Suburban 25%, Rural 25%; p=0.95). Patients from urban communities (UC) presented with more advanced disease by pathological staging than patients from rural communities (RC) (61.5% v 55.6%; p=0.99). The mean tumor size was significantly greater in patients from UCs than RCs (4.8±2.1cm v 1.8±0.1cm; p=0.015). The time from symptom onset to diagnosis was significantly longer for patients from RCs than UCs (390±438 days v 143±86.4 days; p=0.008). Additionally, patients from UCs reported greater mean SNOT-22 scores than RCs (p=0.048). Interestingly, patients from RCs reported a significantly lower ratio of severe to non-severe SNOT-22 symptoms than patients from UCs (p < 0.001).

Conclusions: Although SNM characteristics and staging were similar across geographic locations, patients with SNMs from RCs experienced significant delays in diagnosis and reported lower SNOT-22 scores than those from UCs. These findings highlight the importance of addressing geographic disparities to provide timely diagnosis and treatment for all patients with SNMs.