Background: Several studies have documented disparities in head and neck cancer outcomes for black patients in the United States. However, few studies have been conducted to identify differences in long-term survival from salivary gland cancer amongst racial/ethnic minorities and Whites.

Methods: 6344 cases of salivary gland cancer in the National Cancer Institute’s Surveillance, Epidemiology, and End Results database from 1988-2003 were analyzed. Racial/ethnic groups were studied for disease specific survival. Characteristics of each group including mean age at diagnosis, gender, tumor grade, mean size at diagnosis, extension, lymph node involvement, and treatment were determined. Groups were further analyzed by histologic subtype.

Results: Of 6344 patients, 538 (8.5%) and 253 (4%) were Black and Hispanic, respectively. Twenty-year survival rates for Whites, Blacks and Hispanics were 76%, 83% and 81%, respectively. Blacks had significantly better survival than Whites (p = 0.015). Hispanics also had significantly better survival than Whites (p = 0.0363). This is likely due to the fact that Hispanics and Blacks had significantly lower percentages of high grade tumors. Additionally, the mean age at diagnosis for Whites was 64 compared to 54 and 52 for Blacks and Hispanics, respectively.

There were 2026 cases of mucoepidermoid cancer with 11.9% and 5.2% Blacks and Hispanics, respectively. Twenty-year survival rates in Whites, Blacks and Hispanics were 88%, 89% and 95%, respectively. Hispanics had significantly better survival than Whites (p = 0.049). Hispanics had significantly higher proportions of low grade tumors and less tumor extension at the time of diagnosis when compared to both Whites and Blacks. Additionally, the mean age at diagnosis for Whites was 57 compared to 50 and 47 for Blacks and Hispanics, respectively.

1307 cases of adenocarcinoma with 7.3% and 3.7% Blacks and Hispanics, respectively, were analyzed. Twenty-year survival rates in Whites, Blacks and Hispanics were 60%, 79% and 56%, respectively. Blacks had significantly better survival than Whites (p = 0.319). Hispanics had poorer survival than Whites and Blacks likely due to the fact that they had larger tumor size, higher percentage of metastasis at diagnosis and lower percentage of patients receiving surgery. Whites had a mean age at diagnosis of 64 compared to 61 and 53 for Blacks and Hispanics.

There were 1448 cases of squamous cell salivary gland cancer with 5.7% and 2.4% Blacks and Hispanics, respectively. The difference in survival between the groups with squamous cell cancer was small and not statistically significant.

399 cases of acinar salivary gland cancer with 5.8% and 4.3% Blacks and Hispanics, respectively, were analyzed. Blacks and Hispanics had better survival than Whites, although sample size was small and results were not statistically significant.

Conclusions: Whites with salivary gland cancer have higher mean age at diagnosis than Blacks and Hispanics suggesting a relationship between age and survival in salivary gland cancer. Tumor characteristics likely account for the better survival observed in Hispanics when compared to Whites and Blacks with mucoepidermoid cancer. Poor access to care may be responsible for lower-than-expected survival in Blacks with mucoepidermoid cancer.