Associations of insurance, urbanity, and comorbidity with types of palliative care received by patients with head and neck cancer

Background: Our study examined some of the social and medical factors associated with receiving pain palliation alone over more aggressive cytoreductive palliative measures, such as surgery, chemotherapy, or radiation among patients with head and neck cancer. Methods: This retrospective study used the National Cancer Database 2016 for data analysis. Patient and tumor characteristics were examined using bivariate analysis and logistic regression to identify their association with receiving pain palliation alone versus cytoreductive palliation treatment. Results: Using multivariate logistic regression analysis, insurance status (odds ratio [OR]: 0.27, 95% confidence interval [CI]: 0.15–0.50, p < 0.001), urbanity (OR: 1.73, 95%CI: 1.21–2.46, p = 0.002), and Charlson–Deyo scores greater than 3 (OR: 2.49, 95%CI: 1.38–4.47, p = 0.002) were significantly associated with receipt of pain palliation alone. Conclusions: Clinicians should be aware of non-health-related factors, such as insurance status, that may influence patients' receipt of treatments in head and neck cancer.