Do Ethnicity and Race Put People at Higher Risk for Head and Neck Cancers?

Do genetics or social behavior make head and neck cancers more dangerous for Black people — or is it both?

Aviane Auguste, Ph.D., is the lead author of a study examining head and neck cancer diagnoses among Black patients from Africa, the Caribbean and the United States. The study looked at data from Black women in those locations, and found that head and neck cancer rates were different across regions even though the populations were racially similar.

Auguste said the main discovery of the research was that the environment where people lived had more to do with their risk of developing head and neck cancers than genetic factors.

Women in Kenya had some of the highest rates of head and neck cancer in the study, and researchers noted a cultural factor that could have contributed to that difference.

“Men and women in Kenya developed head and neck cancers at almost the same rate, which is uncommon for these cancers, so we tried to figure out why,” Auguste said. “We found there was a traditional chewing of [a] leaf called khat by both men and women, which could be associated with the increased risk in that population.”

Doctors at the Medical University of South Carolina Hollings Cancer Center suggest that racial differences in head and neck cancer survival rates have both biological and social components.

For example, cases of oropharyngeal cancer, or throat cancer, have increased in the past 20 years — specifically those cases associated with the human papillomavirus (HPV). Marvella Ford, Ph.D., the SmartState Endowed Chair in Prostate Cancer disparities at South Carolina State University and associate director of population sciences and cancer disparities at Hollings Cancer Center, said in an article that white individuals were more likely to get a head and neck cancer diagnosis related to HPV, while head and neck cancer diagnoses among Black people were more likely to be associated with alcohol and tobacco use.

While overall smoking rates among African Americans were only slightly higher than among whites, African Americans were more likely to use menthol cigarettes, which have been found to be harder to quit. Similar behavior was found related to alcohol use: African Americans have lower rates of heavy drinking than whites or other people of color, but research suggests that because of higher rates of other comorbidities, Black patients with significant alcohol use have a higher risk of developing health conditions related to alcohol use.

Unfortunately, non-HPV-related throat cancer has a worse prognosis than HPV-related throat cancer.

Another study looked only at head and neck cancer patients who had diagnoses unrelated to HPV. In that study, Black patients had lower survival rates. The authors suggested the patients’ lower socioeconomic status, which can make it harder for them to access healthcare because of a lack of insurance, transportation and/or education, contributed to those disparities, not their racial backgrounds alone.