BFAM Member Spotlights

Meet the members of the Stanford Medicine Black Faculty Affinity Meetings (BFAM), a network created through OFDD's Community Support Initiative. BFAM is intended to provide networking and social engagement opportunities for Stanford Medicine faculty across all clinical lines and departments.

Uchechukwu Megwalu, MD, MPH

Otolaryngology - Head and Neck Cancer

Chief, Division of Comprehensive Otolaryngology
Otolaryngology Clerkship Director

Research Interests
Outcomes/health services research: health disparities, head and neck cancer, hearing healthcare, health literacy

Full Stanford Profile

Professor of Otolaryngology - Head & Neck Surgery (OHNS)

umegwalu@stanford.edu

Bio

Dr. Megwalu was born in Ottawa, Ontario, Canada, but spent most of his childhood in Nigeria. He received his undergraduate degree from McMaster University in Hamilton, Ontario, Canada. Dr. Megwalu received his medical degree from Washington University School of Medicine, completed his residency at New York Eye and Ear Infirmary, and received his MPH degree from Icahn School of Medicine at Mount Sinai. After residency, Dr. Megwalu joined the faculty at Icahn School of Medicine at Mount Sinai, where he served as Director of Otolaryngology at Queens Hospital Center, and Assistant Regional Director of Otolaryngology for Queens Health Network from 2011 to 2015. Dr. Megwalu Joined the Division of Comprehensive Otolaryngology at Stanford in 2016. His clinical interests include thyroid and parathyroid disorders, head and neck tumors, sinusitis, and chronic ear disorders. Dr. Megwalu conducts outcomes/health services research, with a focus on health literacy, health disparities, and comparative effectiveness research.

Publications

Association Between Limited English Proficiency and Hearing Healthcare Use in the United States. The Laryngoscope Halagur, A. S., Megwalu, U. C. 2024 More

Abstract

To determine whether limited English proficiency (LEP) is associated with likelihood of prior audiogram and hearing aid use among US adults with hearing loss.This cross-sectional study of four merged National Health and Nutrition Examination Survey (NHANES) cycles included 12,636 adults with subjective (self-reported) or objective (audiometric) hearing loss. Subjects were classified as LEP if they completed the NHANES survey in a language other than English, or with the help of an interpreter. Likelihood of audiogram among participants with subjective and objective hearing loss, and likelihood of hearing aid use among participants with objective hearing loss were assessed using unadjusted and adjusted logistic regression.Individuals with LEP were less likely to have undergone audiogram among subjects with subjective (odds ratio [OR] 0.72, 95% confidence interval [CI] 0.67-0.77), and objective (OR 0.70, 95% CI 0.65-0.74) hearing loss. The association persisted for those with subjective hearing loss (OR 0.79, 95% CI 0.72-0.86), and objective hearing loss (OR 0.81, 95% CI 0.73-0.89) after adjusting for relevant covariates. Individuals with LEP were less likely to use hearing aids (OR 0.88, 95% CI 0.84-0.93). This association disappeared (OR 0.99, 95% CI 0.95-1.04) after adjustment.LEP is associated with lower utilization of hearing healthcare services. This may be due to the complex interplay of socioeconomic and language disparities, which may act as barriers to hearing healthcare utilization. Individuals with LEP should be prioritized when designing interventions to improve accessibility to hearing healthcare.Level 3 Laryngoscope, 2024.

View details for DOI 10.1002/lary.31661

View details for PubMedID 39039781
Impact of the COVID-19 Pandemic on Thyroid Cancer Surgery. Current oncology (Toronto, Ont.) Lee, M. L., Megwalu, U. C., Finegersh, A., Noel, J. E., Chen, M. M. 2024; 31 (6): 3579-3590 More

Abstract

The COVID-19 pandemic caused major disruptions to healthcare services in 2020, delaying cancer diagnosis and treatment. While early-stage thyroid cancer often progresses slowly, it is crucial to determine whether treatment delays associated with the pandemic have impacted the clinical presentation and management of advanced-stage thyroid cancer. The purpose of our study was to determine the impact of the early COVID-19 pandemic on thyroid cancer presentation and treatment times. Utilizing the National Cancer Database, chi-squared tests and regression analyses were performed to compare patient demographic and clinical characteristics over time for 56,011 patients diagnosed with primary thyroid cancer who were treated at the Commission on Cancer-accredited sites in 2019 and 2020. We found that thyroid cancer diagnoses decreased between 2019 and 2020, with the biggest drop among patients with cT1 disease relative to other T stages. We also found that patients diagnosed with thyroid cancer in 2020 had similar treatment times to patients diagnosed in 2019, as measured by both the time between diagnosis and start of treatment and the time between surgery and start of radioactive iodine therapy. Overall, our study suggests that resources during the pandemic were allocated to patients with advanced thyroid disease, despite a decrease in diagnoses.

View details for DOI 10.3390/curroncol31060263

View details for PubMedID 38920746
Immigrant Status Disparities in Hearing Health Care Use in the United States. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery Halagur, A. S., Fitzgerald, M. B., Megwalu, U. C. 2024 More

Abstract

To determine whether immigrant status is associated with likelihood of audiogram and hearing aid use among US adults with hearing loss.Cross-sectional study.Nationally representative data from 2009 to 2010, 2011 to 2012, 2015 to 2016, and 2017 to 2020 National Health and Nutrition Examination Survey (NHANES) cycles.This cross-sectional study of 4 merged cycles of NHANES included 12,455 adults with subjective (self-reported) or objective (audiometric) hearing loss. Sequentially adjusted logistic regressions were used to assess the association of immigration status with likelihood of having undergone audiogram among those with objective and self-reported hearing loss, and with likelihood of hearing aid use among candidates with objective hearing loss.Immigrants were less likely to have received an audiogram among subjects with subjective (odds ratio [OR]: 0.81, 95% confidence interval [CI]: 0.75-0.87), and objective (OR: 0.76, 95% CI: 0.72-0.81) hearing loss, compared to nonimmigrants. The association persisted for those with subjective (OR: 0.88, 95% CI: 0.81-0.96), and objective (OR: 0.87, 95% CI: 0.80-0.96) hearing loss after adjusting for sociodemographic factors, comorbidities, insurance, and hearing quality, but disappeared in both groups after adjusting for English proficiency. Immigrants were less likely to use hearing aids (OR: 0.90, 95% CI: 0.87-0.93). However, this association disappeared (OR: 0.98, 95% CI: 0.93-1.04) in the adjusted model.Immigrant status is a significant barrier to hearing health care and is associated with lower rates of audiometric testing and hearing aid use among individuals with hearing loss.

View details for DOI 10.1002/ohn.859

View details for PubMedID 38881377
Insurance Disparities in Quality of Care Among Patients With Head and Neck Cancer. JAMA otolaryngology-- head & neck surgery Megwalu, U. C., Ma, Y., Divi, V., Tian, L. 2024 More

Abstract

Significant insurance status disparities have been demonstrated in head and neck cancer (HNC) outcomes. The effects of insurance status on HNC outcomes may be explained by differential access to high-quality care.To evaluate the association of insurance status with the quality of the treating hospital and receipt of guideline-compliant care among patients with HNC.This retrospective cohort study of data from the California Cancer Registry dataset linked with discharge records and hospital characteristics from the California Department of Health Care Access and Information included adult patients with HNC diagnosed between January 1, 2010, and December 31, 2019. Data were analyzed from May 10, 2023, to March 25, 2024.Insurance status: commercial, Medicare, Medicaid, uninsured, other, or unknown.Quality of the treating hospital (tertiles), receipt of National Comprehensive Cancer Network guideline-compliant care, and overall survival.A total of 23 933 patients (mean [SD] age, 64.8 [12.3] years; 75.3% male) met the inclusion criteria. Treatment in top-tertile hospitals (hazard ratio, 0.87; 95% CI, 0.79-0.95) was associated with improved overall survival compared with treatment in bottom-tertile hospitals. Medicare (odds ratio [OR], 0.78; 95% CI, 0.73-0.84), Medicaid (OR, 0.60; 95% CI, 0.54-0.66), and uninsured (OR, 0.38; 95% CI, 0.29-0.49) status were associated with lower likelihood of treatment in high-quality hospitals compared with commercial insurance. Among patients with advanced disease, Medicaid (OR, 0.72; 95% CI, 0.62-0.83) and uninsured (OR, 0.64; 95% CI, 0.44-0.93) patients were less likely to receive dual-modality therapy. Among patients with surgically resected advanced disease, Medicaid coverage (OR, 0.73; 95% CI, 0.58-0.93) was associated with lower likelihood of receiving adjuvant radiotherapy.This study found significant insurance disparities in quality of care among patients with HNC. These findings highlight the need for continued health insurance reform in the US to improve the quality of insurance coverage, in addition to expanding access to health insurance.

View details for DOI 10.1001/jamaoto.2024.1338

View details for PubMedID 38869878
Update on Pediatric Thyroid Cancer Incidence and Mortality Trends in the United States, 2000-2018. Cancer investigation Li, G., Tai, J. W., Moon, P. K., Megwalu, U. C. 2024: 1-4 More

Abstract

Thyroid cancer is the most common endocrine malignancy in the pediatric population. A recent study has revealed a recent decline in overall US thyroid cancer incidence rates. The aim of this study is to assess whether there has been a corresponding decline in incidence rates in the pediatric population. We used the Surveillance, Epidemiology, and End Results (SEER) database to analyze the pediatric thyroid cancer incidence rate. The results demonstrate that the incidence rate of pediatric thyroid cancer continued to increase from 2000 to 2018. Future studies are needed to understand how recent changes in guidelines are affecting incidence rates.

View details for DOI 10.1080/07357907.2024.2353313

View details for PubMedID 38742680

see all 89 publications

BFAM Member Spotlights

Uchechukwu Megwalu, MD, MPH

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