Disparities in radiation therapy delivery: current evidence and future directions in head and neck cancer

BACKGROUND: Though treatments for head and neck cancer have improved in recent years, significant variation persists in the delivery of surgery, radiation therapy, and systemic therapy to patients throughout the United States. BODY: In this review, we explore the current evidence regarding radiation therapy utilization inequities across the spectra of race, socioeconomic status, and age. We also discuss hypothesized mechanisms for how non-clinical factors may influence shared clinical decisions between patients and providers. Finally, we suggest future directions for research in treatment disparities. CONCLUSIONS: Radiation therapy continues to be delivered inequitably among certain subpopulations with head and neck cancer and other cancers. More research into the drivers of these disparities and interventions designed to address them are necessary.