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
Oncology , Third 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.