Delivering Timely Head and Neck Cancer Care to an Underserved Urban Population-Better Late Than Never, but Never Late Is Better.

Despite aggressive multimodal therapy consisting of combinations of surgery, radiotherapy, and chemotherapy, patients with locally advanced head and neck squamous cell carcinoma (HNSCC) have a poor prognosis, with 5-year survival rates hovering around 50%. This suboptimal survival is even worse for racial/ethnic minorities and underinsured patients with HNSCC, who experience significantly higher rates of mortality relative to their white and well-insured peers. 1,2 Therefore, HNSCC is a cancer for which strategies to improve survival and equity are desperately needed. In light of this need, it is becoming abundantly clear that the manner in which we deliver cancer care to patients with HNSCC has significant potential as a modifiable target to drive improvements in survival and decrease disparities in outcomes. 3 Delays in cancer care delivery across the continuum contribute to excess mortality for patients with HNSCC, disproportionately burden racial/ ethnic minorities and underinsured patients, and are a key contributor to disparities in survival for racial/ethnic minority and underinsured populations. 3–5 Against this background, the article by Liao et al 6 in this issue of JAMA Otolaryngology-Head & Neck Surgery reverberates as a renewed call to understand the complicated system of care delivery for patients with HNSCC and how it continues to fail our most vulnerable patients. By supplementing the existing body of evidence that delays in HNSCC care are key drivers of excess mortality and disparities in outcomes, their findings add to the growing clarion call to recognize the devastating oncologic consequences of treatment delays in