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Objectives/Hypothesis Dysphagia is a treatment‐related complication of head and neck cancer (HNCA). We demonstrate the predictive value of a modified head and neck swallow scale (m‐HNSW) adapted from the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire‐Head and Neck 35 (EORTC‐QLQ‐H&N35). Study Design Retrospective Cohort Study. Methods Retrospective, single‐center cohort study utilizing a prospectively collected database of HNCA patients in a high‐volume tertiary referral center. 736 HNCA patients more than 2 years from completion of treatment were identified. EORTC‐QLQ‐H&N35 data collected from at least one of three defined episodes of care were used. The m‐HNSW uses three questions to form a 9‐point dysphagia scale. A Cox proportional hazards model was used to determine the effect of the m‐HNSW while controlling for demographics, tumor staging, site, and treatment. Results Using data from 3, 6, 12 months from treatment, we analyzed a subset that included 328 patients. Three months after the completion of therapy, the m‐HNSW score had a significant association with 1 (HR = 1.24, P = .0005) and 5 year survival (HR = 1.19, P = .0002) after accounting for body mass index. Six (HR = 1.14, P = .014) and 12 month (hazard ratio (HR) = 1.33, P < .0001) scores post completion of therapy predict 5‐year survival. An increase of the m‐HNSW score by 1 point was associated with an increase in death by 24%, and 19% at 1 and 5 years following therapy. Conclusions The m‐HNSW is a simple assessment of dysphagia using previously validated EORTC‐QLC‐H&N35 data that when taken at 3, 6, and 12 months after completion of therapy is predictive of overall survival. Level of Evidence 4 Laryngoscope, 131:2478–2482, 2021

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