Heath Disparities Driving a Lack of Equity in Head and Neck Cancer Research
Seth Z. Aschen, MD, MBA, Jason A. Spector, MD
Weill Cornell Medical College Division of Plastic and Reconstructive Surgery, Weill Cornell Medicine, Ithaca, NY
Purpose: - In the United States there are over 10,000 deaths related to head and neck cancers each year. There has been a major shift in the pathophysiology of head and neck cancers with 16% of disease identified as HPV positive in the 1980s increasing to 72% in the 2000s. A strong male predominance in the disease burden persists with male to female disease ratios ranging between 2:1 and 4:1. Compared to Breast and colon cancer, head and neck cancers have the lowest 5-year survival at 60% versus 90% and 65% for breast and colon respectively. This study quantifies the relative disparities that exist for research funding and public outreach between head and neck and other common cancers. Methods: - The NIH “Support Service Locator” was queried with the search terms “head and neck cancer”, “breast cancer”, and “colorectal cancer” with the resultant organizations recorded. The IRS tax exempt organization search tool was then queried with the same search terms and the number or resulting organizations was documented. The GuideStar nonprofit search tool was used to determine the gross receipts of the top five resulting organizations in each category. Finally, the number of American Cancer Society Grants and NCI funding levels for the above disease were calculated. Result:s - There were 53,000 head and neck cancers, 271,270 breast cancers, and 153,900 colorectal cancers in 2019 within the US. The support service locator on the NIH website returned 2 organizations for head and neck cancers, 8 organizations for breast cancer, and 4 organizations for colorectal cancer. The number of tax-exempt organizations identified for these cancers were 11, 639, and 12 respectively. The gross receipts for the top non-profit organizations for these three cancers totaled $2.6 million, $324 million, and $20.4 million respectively. As of March 2020, the ACS and NCI had grants totaling $75 million, $614 million, and $232 million respectively. Conclusion:s - Public perception associates head and neck cancer with activities of vice contributing to chronic underfunding of their study with little progress in available treatments. Public awareness and advocacy resources available to head and neck cancer patients pale in comparison to those resources available to patients with other types of cancer. Recognizing that head and neck cancer patients have limited resources and more difficulty advocating for their needs highlights the importance of establishing more public and private mechanisms to direct resources to this underserved population.
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