Demographics and Trends in Outpatient Surgery for Laryngeal Cancer: 2016-2021.

Abstract

Objective: To analyze the utilization patterns of outpatient laryngoscopic excision procedures for laryngeal cancer in the United States, examining procedural costs and patient demographics to identify disparities in healthcare access.

Study design: Retrospective cohort study.

Setting: National Ambulatory Surgery Sample database of major ambulatory surgeries in the United States, 2016-2021.

Methods: Encounters for endoscopic resection of laryngeal cancers were identified focusing on patient demographics and procedural costs. Analysis was performed regarding trends over time.

Results: Of 11,371 encounters in 2016-2021, patients were mostly male (82.6%), White (75.3%), and living in metropolitan areas with greater than 1 million residents (54.1%), with an even distribution between income quartiles. Predictors of utilization at urban teaching hospitals progressively decreased in patients residing in smaller metropolitan areas (250-999,000 residents (odds ratio [OR] = 0.451, P ≤ .0001) and 50-249,000 residents (OR = 0.193, P ≤ .0001). Higher utilization was found in non-White patients (Black [OR = 1.673, P = .0075], Hispanic [OR = 1.752, P = .0118]), and those with patients with higher income (2nd quartile [OR = 1.411, P = .0058], 3rd quartile [OR = 2.017, P ≤ .0001], and 4th quartile [OR = 4.422, P < .0001]). These findings were consistent on multivariate analysis, however belonging to a racial minority lost significance (Black patients [P = .0508], Hispanic [P = .3008]).

Conclusion: There are existing disparities in endoscopic resection of laryngeal cancers. Our findings add to the literature underscoring the importance of expanding access to minimally invasive laryngeal preserving surgical treatment.