14 DAY TRIAL // A new study led by Maria J. Worsham, PhD, director of research in the Department of Otolaryngology at Henry Ford Hospital, suggests that head and neck cancer outcomes linked with race should rather be associated with social and behavioral factors instead.
Apparently, even if African Americans have higher risks of having late stage cancer, there no relation between the patients' genetic ancestry and cancer stage or survival.
Dr Worsham and her team studied 358 patients, out of which 37% were African American.
The researchers looked at the diagnosis – early stage vs. late stage, and general survival for African Americans with head and neck squamous cell carcinoma – HNSCC, based on self-reported race and genetic West African Ancestry.
Detecting genetic ancestry among major ethnic groups like Asians or West Africans is possible, thanks to well developed sets of single nucleotide polymorphism markers, called ancestry information markers, or AIMs.
For this research, the genetic ancestry determination panel included 100 AIMs.
Dr. Worsham said that “using these genetic markers gives you additional statistical power, [because] it's no longer two just categories - Black or White; it becomes a continuous variable.
“Race is not equal to genetics, and genetic markers don't define specific races,” she adds.
The results of the study strengthened the idea that there is no correlation between HNSCC outcomes and West African genetic ancestry, and only self-reported race was associated with head and neck cancer stage.
5% of self-reported African Americans had over 95% of West African ancestry and 27% had less that 60% West African ancestry, and if we extrapolate, 48% self-reported Caucasians had more than 95 percent European American ancestry.
“We believe this is the first piece of evidence using genetic race to take a closer look at outcomes with respect to stage – early or late – and survival in patients with head and neck cancer,” says Maria J. Worsham, the lead author of the study.
“We know that African Americans are disproportionately diagnosed with late-stage cancer and have worse outcomes than Caucasians,” she explains.
“While there has been no real consensus on the causes for this difference, it is possible access to care, stage at diagnosis and insurance status may be factoring into the equation.”
Last year, there were almost 35,720 new cases of HNSCC and nearly 7,600 deaths, and the main risk factors for this type of cancer are smoking and alcohol use.
According to statistics, African Americans are more likely to be diagnosed with late-stage HNSCC and have lower survival chances than Caucasians, but no one knows whether it is the significant biological or the socioeconomic differences that are responsible for some of the disparities in outcomes.
Dr Worsham explained that “the goal of using genetic ancestry is not to point out differences, but relatedness, [as] health disparities within certain racial groups are very real, and what we're trying to achieve in terms of learning more about head and neck cancer is a leveling of the playing field to better diagnose and treat patients.”
The results of the study results were presented yesterday at the American Academy of Otolaryngology–Head & Neck Surgery Foundation Annual Meeting in Boston.