2016年，美国食品和药品管理局批准了免疫检查点抑制剂（免疫疗法）用于特定头颈部鳞状细胞癌（HNSCC）的个案。然而，尚不清楚接受免疫疗法患者之间是否存在临床或社会人口学差异。鉴于头颈部癌症护理中已知的差异，我们假设根据临床和非临床特征，HNSCC患者接受免疫疗法存在差异。本研究的目的是描述与HNSCC老年患者接受免疫疗法相关的临床和非临床因素。该回顾性队列研究包括了在社区肿瘤护理环境中被诊断为HNSCC的65岁或以上的患者（n = 4860）。该研究评估了Navigating Cancer的电子病历，时间范围为2017年1月1日至2022年4月30日。采用多变量Logistic回归来描述与接受免疫疗法相关的临床因素（肿瘤分期[局部化 vs 高级]和解剖部位[咽喉部 vs 非咽喉部]）和非临床因素（年龄、吸烟史、种族和民族、性别和婚姻状况）。在4860名患者的研究队列中，有3593名（73.9%）为男性；4230名（87.0%）为白种人，有630名（13.0%）为其他种族。共有552名患者（11.4%）接受了免疫疗法。在校正协变量后，最终模型显示，与其他种族患者相比，HNSCC的白种患者接受免疫疗法的可能性增加了80%（调整后的比值比[AOR]，1.80 [95% CI，1.30-2.48]）。而根据年龄、性别或吸烟史来判断是否接受免疫疗法的概率没有统计显著差异。非咽喉部疾病的患者接受免疫疗法的可能性显著高于咽喉癌患者（AOR，1.29 [95% CI，1.05-1.59]），与局部疾病相比，晚期疾病的患者接受免疫疗法的可能性也更高（AOR，2.39 [95% CI，1.71-3.34]）。本队列研究的结果表明，在HNSCC老年患者中，白种人可能更有可能接受免疫疗法作为其治疗的一部分。公平获得免疫疗法和其他治疗选择将减少癌症相关的健康差距并改善HNSCC患者的生存率。

The US Food and Drug Administration approved immune checkpoint inhibitors (immunotherapy) for select cases of head and neck squamous cell carcinoma (HNSCC) in 2016. However, it is unclear whether there are clinical or sociodemographic differences among patients receiving immunotherapy as part of their care. Given the known disparities in head and neck cancer care, we hypothesized that there are differences in receipt of immunotherapy among patients with HNSCC based on clinical and nonclinical characteristics.To characterize clinical and nonclinical factors associated with receipt of immunotherapy among older patients with HNSCC.This retrospective cohort study included patients 65 years or older diagnosed with HNSCC (n = 4860) in a community oncology care setting. Electronic health records from Navigating Cancer were assessed from January 1, 2017, to April 30, 2022.Multivariable logistic regression was used to characterize clinical (tumor stage [localized vs advanced] and anatomical subsite [oropharyngeal vs nonoropharyngeal]) and nonclinical (age, smoking history, race and ethnicity, sex, and marital status) factors associated with receipt of immunotherapy.In the study cohort of 4860 patients, 3593 (73.9%) were men; 4230 (87.0%) were White and 630 (13.0%) were of other races. A total of 552 patients (11.4%) had received immunotherapy. After adjusting for covariates, in the final model, White patients with HNSCC had 80% increased odds of receiving immunotherapy (adjusted odds ratio [AOR], 1.80 [95% CI, 1.30-2.48]) compared with patients of other races. There were no statistically significant differences in the odds of receiving immunotherapy based on age, sex, or smoking history. Patients with nonoropharyngeal disease were significantly more likely to receive immunotherapy than those with oropharyngeal cancer (AOR, 1.29 [95% CI, 1.05-1.59]), as were those with advanced compared with local disease (AOR, 2.39 [95% CI, 1.71-3.34]).The findings of this cohort study suggest that among older patients with HNSCC, White patients may be more likely to receive immunotherapy as part of their care. Equitable access to immunotherapy and other treatment options will reduce cancer-related health disparities and improve survival of patients with HNSCC.