Jed A. Katzel, MD, Hematology, Kaiser Permanente Santa Clara Medical Center, discusses differences in treatment decisions between men and women with head and neck cancer.

Research presented at the 2018 ASCO Annual Meeting showed that women are more likely to succumb to their head and neck cancer than men, compared with other causes. In an attempt to explain these findings, a logistic regression analysis was used to account for any differences in intensive therapy between the sexes. After controlling for factors including age, smoking history, alcohol history, Charlson Comorbidity Index, and site of the primary cancer, women were found to be less likely to receive intensive chemotherapy and radiation therapy than men.

More men were enrolled in the trial than women, admits Katzel, which he says accurately reflects the higher prevalence of head and neck cancer in men. These findings will undergo further review, chart-by-chart, to better understand why some patients, specifically women elect to receive or to forego intensive therapy, he concludes.

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Dr. Katzel on Differences in Therapy Between Men and Women With Head and Neck Cancer

Jed A. Katzel, MD, hematology, Kaiser Permanente Santa Clara Medical Center, discusses why women with head and neck cancer are undertreated.

A study done in Northern California found that women are more likely than men to die from head and neck cancer compared with other causes, even when generalized competing events (GCE) analysis considered tumor location and stage, states Katzel.

Compared with men, women were less likely to receive intensive chemotherapy (35% vs 46%; 

 = .008). More research needs to be done to figure out why that is the case, says Katzel.

In the analysis, researchers also found that there was a statistically significant difference in tumor location. The rate of oropharyngeal cancer in women was 38%, whereas the rate of oropharyngeal cancer in men was 55%, says Katzel. Oropharyngeal cancer is more likely to be HPV related. HPV-related head and neck cancer has a better prognosis and a better response to therapy, notes Katzel. Further research will include a chart-by-chart review as well as the upcoming NRG-HN004 clinical trial that will use the GCE model prospectively.

Jed A. Katzel, MD

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Dr. Katzel on Differences in Therapy Between Men and Women With Head and Neck Cancer

Dr. Katzel on Why Women With Head and Neck Cancer are Undertreated