Why are African Americans more likely than whites to be not only diagnosed with head and neck cancer, but also die from the disease?

A study finds that blacks are more likely to be past or current smokers, one of the primary risk factors for head and neck cancer. African Americans are more likely to be diagnosed with late-stage head and neck squamous cell carcinoma (HNSCC) and have a worse five-year survival than whites. African Americans are more likely to be unmarried or living alone, both of which previous studies suggest have a negative impact on quality of life and survival. In terms of cancer treatment, African Americans are more than two times more likely than whites to receive radiation therapy. Often times, if the tumor is extensive or it is not feasible to completely remove it, radiotherapy is initially given to try to shrink the tumor. Fewer African Americans (43%) opted for surgery than whites (49%). African American tumors are six to seven times more likely to present with lymphocytic response, which essentially is an entourage of immune system cells. These cells behave not only as first responders against tumors, but can also produce growth factors (chemicals) that feed tumor growth, such as forming blood vessels. Compared to the tumors of whites, African American tumors were almost two times more likely to have loss of the CDKN2A (cyclin-dependent kinase inhibitor 2A) gene and gain of the SCYA3 (small inducible cytokine A3) gene. CDKN2A is important to cell cycle regulation, and the SCYA3 gene product has dual roles of tumor lymph node metastasis and local host defense against tumors in HNSCC.