ABSTRACT
Most information on demographic and socioeconomic factors reported in the head and neck oncology literature is on the association of these variables with the risk of developing a head and neck squamous cell cancer (HNSCC), the risk of having an advanced clinical stage disease at diagnosis, and eventually the possibility of receiving or not optimal treatment. In this chapter we will focus on the value of demographic variables as prognostic factors. It is of paramount importance to take into account that demographic factors influence the prognosis mainly through their close relationship with two universally accepted prognostic factors, clinical stage of the disease at diagnosis and treatment approach. The typical situation can be understood when considering the association between advanced age and standard treatment. In developing countries, elderly patients are more likely to be offered a ‘less morbid treatment,’ which is most often not the ‘optimal treatment,’ and thus, they have a poorer prognosis1,2. Furthermore, but not only in developing countries, socio-economic status can be an indicator of disparities in health care access and can thus be related to advanced clin-
ical stage at diagnosis and unavailability of some sophisticated treatment approaches3. This can also explain some of the differences in prognosis observed when patients treated in developing countries are compared to those treated in developed ones4.
