DESIGN
The National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) database (SEER-18 registry, November 2019) was used to identify HNCs reported first at autopsy from 2000 to 2017.6 Patients with HNC were identified using primary site-labeled variables in the SEER*stat program. Skin cancers were excluded. Thyroid carcinoma was analyzed separately from non-thyroid carcinoma. The following data were collected: age group, gender, race, tumor site, histological type, tumor staging, tumor size, median household income, and cause of death. Tumor histological behaviors were classified based on International Classification of Diseases for OncologyThird Edition  (ICD-O-3 ).7Tumor staging data was derived from the American Joint Committee on Cancer (AJCC), 6th edition.8 Median household income was adjusted to 2018. Fisher’s Exact Test identified correlation data for cancer-related cause of death for in laryngeal, non-thyroid head and neck, and thyroid carcinoma and age, stage, median household income, site, race, sex, and tumor size. Patient age was categorized as follows: under 30, 30-50, 50-70, and above 70 years old. Cancer stage was dichotomized into early stage (1 and 2) and late stage (3 and 4). Patients were also categorized into groups based on household income: under $35,000; $35,000-$50,000; $50,000-$75,000; and above $75,000. Tumor size was evaluated in groups of smaller and larger than 4cm. IBM SPSS Build 1.0.0.1327 statistics was used to perform all the analysis. The study was designated exempt by the Institutional Review Board at our center.