Characterization of Otolaryngology Referrals among Pacific Islanders in the Commonwealth of the Northern Mariana Islands

The burden of otolaryngology disease in Pacific Islander populations is relatively uncharacterized. A single-institution retrospective review was undertaken at the Commonwealth Healthcare Corporation in Saipan, the only hospital in the Commonwealth of the Northern Mariana Islands. Demographic, diagnostic, and treatment data were compiled from the clinical charts of all patients seen by an otolaryngologist between January 2015 and April 2020. For all Pacific Islanders in the sample (N=674), the average age was 40.2 (SD 22.4) years and ages ranged from 10 months to 89 years. Patients were 50.7% male and 49.3% female. The most common diagnoses affected the ear (40.8%), followed by the oral cavity/pharynx (23.2%), and nose (14.0%). Middle ear disease comprised 41.7% of reported ear disorders; the most common problem was otitis media (19.4%, n=68) followed by tympanic membrane perforation (14.0%, n=49). Head and neck cancers comprised 8.6% of all diagnoses. Most (77.8%) malignant neoplasms were oral cavity carcinomas. The average age at diagnosis for oral cancer was 46.6 years with a 1.8:1 male-to-female predominance. Patients with cancer of the oral cavity (n=56) chewed betel nut at higher rates (94.6%) compared with other adults in the sample (P<.001). Adult patients reported alcohol use, smoking, and chewing betel quid at rates of 26.5%, 39.9%, and 52.2% respectively. Otolaryngology referrals among Pacific Islanders in this sample were dominated by ear disease and included betel nut-related oral cavity disease.