Background Racial outcome disparities have been observed in HNSCC with diminished survival for black patients compared to whites. Methods We retrospectively analyzed 1318 patients with primary HNSCC treated at the UMGCC from 2000 to 2010. Results 65.9% were white, 30.7% were black and 3.3% were of other races. Blacks were less likely to present with oral cavity cancer (OC), and more likely to present with laryngeal or hypopharyngeal cancers. Whites were more likely to have early stage disease, especially in the OC. Black race was independently associated with worse OS in the entire cohort. Blacks had a significantly worse OS amongst OC and oropharyngeal cancers (OPC), with the largest disparity in OPC. However in multivariate analysis race was only still significant in OPC. Conclusion We observed differences by race in distribution of disease site, stage, and OS. Survival disparity in the entire cohort was driven mostly by differences amongst OPC.

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