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Video

Head and Neck Surgery

(A563) Impact of Travel Distance on Staging at Presentation and Survival in Oral and Oropharyngeal Cancer

Monday, October 13, 2025
12:00 PM - 1:00 PM EDT
Location: OTO EXPO, Posters

    Presenting Author(s)

  • Steven C. Goicoechea, MD

    House Officer
    University of Nebraska Medical Center, Department of Otolaryngology-Head and Neck Surgery
    Omaha, Nebraska, United States

    • Co-Author(s)

  • TS

    Tony D. Satroplus, MD

    House Officer
    University of Nebraska Medical Center, Department of Otolaryngology-Head and Neck Surgery
    Omaha, Nebraska, United States

  • KS

    Kaeli Samson, MPH

    University of Nebraska Medical Center, College of Public Health, Department of Biostatistics, United States

  • TR

    Tony Richa, MD

    Assistant Professor
    University of Nebraska Medical Center, Department of Otolaryngology
    Omaha, NE, United States

    • Senior Author(s)

  • EB

    Elizabeth J. Bradford Bell, MD

    Assistant Professor
    University of Nebraska Medical Center, Department of Otolaryngology-Head and Neck Surgery
    Omaha , NE, United States

Disclosure(s):
Steven C. Goicoechea, MD: No relevant relationships to disclose.
Tony D. Satroplus, MD: No relevant relationships to disclose.
Elizabeth J. Bradford Bell, MD: No relevant relationships to disclose.


Introduction: Socioeconomic factors have a well-documented impact on staging at presentation and survival for patients with head and neck squamous cell carcinoma (SCC). The effect of distance to treatment is poorly understood and has not been analyzed with a national database.

Methods: Hospital-based multicenter retrospective review of adult patients with oral and oropharyngeal SCC in the National Cancer Database from 2018 to 2021. Independent variables included overall stage at initial presentation and 24-month survival. Adjusted odds ratios (AORs) for advanced diagnoses based on travel distance were derived from logistic regression models, which adjusted for age, sex, race, ethnicity, education, income, insurance status, and year of diagnosis. Cox proportional hazards regressions were used to generate adjusted hazard ratios (AHRs) for survival.

Results: A total of 37,062 patients were identified with mean age of 63.6 years, 74% male, and 13% non-white race. Oral SCC accounted for 43% and oropharyngeal SCC 57%. Among patients with oropharyngeal SCC, patients had lower adjusted odds of being diagnosed at stage 3 or 4 relative to those who lived 10 miles from the treatment center if they lived 50 miles (AOR=0.83, 95% CI: 0.75-0.90, p< 0.001) or 100 miles away (AOR=0.77, 95% CI: 0.69-0.86, p< 0.001). Among patients with oral SCC, there was a lower adjusted risk of death in those that lived 50 miles away (AHR=0.83, 95% CI: 0.75-0.91, p< 0.001) or 100 miles away (AHR=0.73, 95% CI: 0.65-0.81, p< 0.001) relative to 10 miles away. Among patients with oropharyngeal SCC, there was a lower adjusted risk of death in those that lived 50 miles away (AHR=0.74 95% CI: 0.65-0.83, p< 0.001) and 100 miles away (AHR=0.64, 95% CI: 0.55-0.75, p< 0.001) compared to those who lived 10 miles from the treatment center.

Conclusions: Patients with greater distance to treatment had a lower odds of presenting with advanced oropharyngeal SCC. This finding was not significant for oral SCC. Among patients with oral and oropharyngeal SCC, those with greater distance to treatment tended to have improved survival.