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Late-Breaking Scientific Oral Presentations

Care Equity, Quality, and Safety

Session: Late Breaking Scientific Orals 1

Differences of Community-Level Vulnerability Impact on Early- and Later-Onset Nasopharyngeal Cancer Prognosis in the US

Saturday, October 11, 2025

2:36 PM - 2:42 PM EDT

Location: 245

Introduction: As cancer diagnoses have increasingly affected younger demographics across multiple histology types, studies have surmised multiple non-clinical and social drivers of this concerning trend to be the crux behind the exacerbated outcomes for younger patients. However, age-related differences in care and prognosis have yet to be assessed among patients with nasopharyngeal carcinoma (NPC), especially across SDoH-factors beyond race-ethnicity.

Methods: This retrospective cohort study on 11,590 NPC-patients from 1975-2017 linked with 15 county-level vulnerability measures encompassing socioeconomic status (SES), minority-language status (ML), household composition (HH), housing-transportation (HT), and a total/composite vulnerability themes were assessed via adjusted linear and logistic regression analyses stratified across age groups of 20-44 years (younger) and ≥45 years (older) for outcomes of survival, multimodal treatment, and advanced staging.

Results: Increased total vulnerability was associated with 45% (78.3 to 43.1 mths) reductions in survival period among younger ages but only 22% (50.8 to 39.9 months) decreases among older ones. Increased total vulnerability was associated with increased chemotherapy (OR 1.17; 95%CI 1.10-1.24) and decreased external beam radiotherapy (OR 0.78; 95%CI 0.71-0.85) among younger groups compared to similar but diminished differences in chemotherapy (1.07; 1.04-1.11) and external beam radiotherapy (0.87; 0.84-0.90) for older ones. Increasing total vulnerability also showed similarly increased advanced staging across ages (younger-1.09; 1.03-1.11; older-1.09, 1.06-1.13). By magnitude, HH and SES-vulnerabilities contributed to these trends over ML and HT.

Conclusions: Increasing social vulnerability was associated with detrimental survival and treatment NPC-trends, with younger patients experiencing substantially higher effects compared to older adults. With these trends largely contributed by HH and SES-drivers, these results present actionable targets for prospective efforts tackling the growing concerns of early-onset NPC.

Co-Author(s)

David J. Fei-Zhang, MD, MBA

Resident - Otolaryngology-Head and Neck Surgery
Northwestern University - Feinberg School of Medicine
Chicago, Illinois, United States

Disclosure information not submitted.

Presenting Author(s)

Eric Pan, BS

Medical Student
Medical College of Georgia
Augusta, GA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

Eric Pan, BS

Medical Student
Medical College of Georgia
Augusta, GA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
Daniel C. Chelius, Jr., MD

Associate Professor
Baylor College of Medicine / Texas Children's Hospital
Houston, TX, United States

Disclosure information not submitted.
Jill N. D'Souza, MD

Associate Professor of Otolaryngology- Head and Neck Surgery
Louisiana State University Health and Sciences Center
New Orleans, LA, United States

Disclosure information not submitted.
AS

Anthony M. Sheyn, MD

Division Chief, Pediatric Otolaryngology
Le Bonheur Outpatient Center
Memphis, Tennessee, United States

Disclosure information not submitted.
Jeffrey C. Rastatter, MD

Associate Professor
Ann & Robert H. Lurie Childrens Hospital of Chicago
Chicago, IL, United States

Disclosure information not submitted.

Senior Author(s)

Jeffrey C. Rastatter, MD

Associate Professor
Ann & Robert H. Lurie Childrens Hospital of Chicago
Chicago, IL, United States

Disclosure information not submitted.