Is there disparity in the care of minority patients with upper aerodigestive tract malignancy?

The data presently available indicate that there is unequal (disparate) care in patients with head and neck cancer. The reasons for this are likely multifactorial and require further study. Complicating such work is the need for subgroup analysis. For example, Hispanics are not a homogeneous ethnic group; hence, differences in social perception, cultural mores, and available medical resources can be demonstrated that can directly impact care and outcome. Appropriate epidemiologic studies are needed with more underserved minority patients to analyze these differences further and to address such differences.

Geographical distribution of respiratory cancer in New Caledonia.

All cases of primary respiratory cancers diagnosed between 1/1/78 and 12/31/81 in the French territory of New Caledonia, where nickel has been mined and smelted for more than one hundred years, were recorded. The successive addresses of each case were noted. The distribution of stays between mining zones and others was compared to an expected distribution based on censuses. A significant excess was observed in mining zones, both for the number of stays and for the number of person-years. The excess was observed for primary lung cancer only. The data seem to indicate that people with lung cancer have spent a larger part of their life in a mining zone. The reason for that phenomenon cannot, however, be assessed clearly. This could be due to the geographical environment, i.e., the presence of nickel and asbestos in the soil of some parts of the territory; the observed relationship could also be due, in part, to the effects of urbanization leading to increased tobacco consumption.