Medical Student Wins Top Honors for Cancer Health Disparities Research
Studies examine laryngeal cancer in Florida and early cancer detection.
When it comes to difficult cancers, such as head and neck, Sylvester Comprehensive Cancer Center provides leading research with its array of experts. Among these researchers are medical students from the University of Miami Miller School of Medicine like Uche Ezeh, who earned top honors for his research and presentation on disparities in survival from laryngeal cancer at the American Head and Neck Society’s International Conference on Head and Neck Cancer.
“I knew I found my calling in this specialty, as I found ENT to be the most anatomically complex but intriguing,” said Ezeh, who is in his fourth year at the Miller School. “From witnessing my first head and neck surgery to embarking on a research year in otolaryngology and now earning these recognitions, it’s truly a full-circle moment as I plan to continue in this field for my residency.”
Florida Laryngeal Cancer Cases
Laryngeal cancer is one of the most common head and neck malignancies. Tobacco use and alcohol consumption are well-established risk factors for the disease, which predominantly affects males aged 60 to 70 years. Recent studies show that the incidence of malignancy has decreased over time in the United States, but mortality rates have not decreased at the same rate.
Ezeh’s research project, “Racial and Geographical Disparities in Diagnosis and Survival of Hypopharyngeal/Laryngeal Cancers in Florida Between 2010–2017,” aimed to gain a deeper understanding of this trend. To complete the study, Ezeh acquired data from the Florida Cancer Data System and collaborated with one of his mentors, Dr. Elizabeth J. Franzmann, M.D., professor and director of head and neck research at the Miller School, to identify which racial, clinical and socioeconomic factors affect survival from hypopharyngeal/laryngeal cancer in Florida.
“While national trends related to this cancer are well documented, there is insufficient information at the local level,” Ezeh said. “We examined the Florida database and identified 11,407 adult patients with hypopharyngeal or laryngeal cancer, which was narrowed to 6,771 after considering inclusion and exclusion criteria.”
With the help of Ming Lee, M.D., Ph.D., a fellow in the Cancer Control Training in Disparities and Equity Program at Sylvester, the research cohort was able to map these patients geographically and show that, at the census level, mortality rates for hypopharyngeal and laryngeal cancer were highest in northern Florida when compared to central and southern Florida. Additionally, the highest mortality rates were characterized by lower income and education levels.
“Our data showed that the risk for hypopharyngeal/laryngeal cancer in Florida was greatly affected by sex, ethnicity, geographical location, marital status, insurance and smoking status,” Ezeh said. “Interestingly, there was no significant difference in survival between Black and white non-Hispanic patients, but [there was] a survival advantage among white Hispanics compared to white non-Hispanics.”
“These types of projects typically look at whether there is a disparity, but my study will take it further to see what actionable steps we can do to intervene,” Ezeh added. “I plan on refining the data further and examining survival rates within Miami-Dade County, to focus on regions that have lower income and limited educational resources.”
Accessible Head and Neck Cancer Detection Methods
Ezeh also presented “CD44 in Oral Rinses Is an Adjunct to Early Detection of Cancer and Premalignant Lesions in High-risk Groups Facing Healthcare Disparities,” a project that involved research from Dr. Franzmann’s lab.
“Currently, diagnoses for head and neck cancers occur in later stages in minority communities due to the many barriers to health detection, such as specialist fees, referrals and lab work,” Ezeh said. “The goal of this project was to find a cheaper, safer and more accessible way of detecting head and neck cancer to prevent early mortality.”
The lab developed a community screening program with 150 participants who are current or former smokers from low-income communities. The study spanned 10 years, during which participants underwent an oral rinse procedure to identify and measure the presence of tumorigenic biomarker soluble CD44 and total protein. Results revealed that out of the 150 participants, nine individuals developed various forms of cancer, including esophageal carcinomas, lung cancer and tongue cancer. Strikingly, eight of these nine cancer cases were detected within the initial three years of the study. This early detection was attributed to higher CD44 levels, averaging around 1.849 ng/mL, compared to the 1.779 ng/mL observed in those without cancer. These findings underscore the effectiveness of CD44 in the early detection of head and neck cancer.