ABSTRACT
BACKGROUND: Neighborhood socioeconomic deprivation impacts outcomes in various cancers. We examined this association in nasopharyngeal carcinoma (NPC) patients using the area deprivation index (ADI). METHODS: We conducted a single-institution retrospective cohort study on NPC patients treated with definitive radiotherapy from 1980 to 2023. ADI was used as the primary exposure measure. Higher ADI indicates higher levels of socioeconomic deprivation. RESULTS: Of 561 patients, those with higher ADI (6-10 vs. 1-5) presented more commonly with AJCC stage III/IV compared to I/II (87% vs. 76%, p = 0.03). Increasing ADI decile score correlated with poorer overall survival (HR 1.14, 95% CI 1.01-1.28, p = 0.04). Local control was worse in patients from the most deprived quartile in the cohort ADI 5-10 (HR 2.11, 95% CI 1.01-4.41, p = 0.05). CONCLUSIONS: NPC patients from more disadvantaged neighborhoods undergoing radiotherapy had worse local control and survival outcomes. Interventions to address structural determinants of health and neighborhood disparities may improve these outcomes.
Subject(s)
Nasopharyngeal Carcinoma , Nasopharyngeal Neoplasms , Humans , Male , Female , Retrospective Studies , Nasopharyngeal Carcinoma/mortality , Nasopharyngeal Carcinoma/pathology , Nasopharyngeal Carcinoma/radiotherapy , Nasopharyngeal Carcinoma/therapy , Middle Aged , Nasopharyngeal Neoplasms/mortality , Nasopharyngeal Neoplasms/pathology , Nasopharyngeal Neoplasms/radiotherapy , Adult , Aged , Cohort Studies , Socioeconomic Factors , Neoplasm Staging , Survival Rate , Neighborhood CharacteristicsABSTRACT
Introduction: Sensory discomfort occurs in clinical and non-clinical populations. While some of the parameters that evoke visual discomfort have been identified, the parameters of sounds that evoke auditory discomfort are largely unknown. Methods: We presented various sounds and asked participants to rate the discomfort they experienced. In Experiments 1 and 2 tones were presented at frequencies between 0.25-8 kHz and modulated sinusoidally in amplitude at frequencies between 0-32 Hz. In Experiment 3 tones were swept in frequency from 500 Hz-2 kHz at sweep rates of 5-50 per second. In Experiment 4, sweeps varied in frequency range and central frequency. Results: Discomfort increased with frequency. The effects of the amplitude modulation and sweep rate on discomfort were relatively small and were experienced mainly at low modulation frequencies and high sweep rates. Individuals who experienced visuo-perceptual distortions in the Pattern Glare (PG) Test reported greater auditory discomfort. Discussion: This suggests that sensory sensitivity in one modality may occur in another.
