Assessment of conditions leading to lost-to-follow-up of head and neck cancer patients

Dimon, Erin; Simmons, J. Kai; Ziegler, Andrea; Bollman, Molly; Bur, Andrés M.; Nallani, Rohit; Smith, Jane Kapler; Cummings, Emily; Fassas, Scott; Kakarala, Kiran; Shnayder, Yelizaveta; Sykes, Kevin J.

doi:10.1016/j.amjoto.2022.103443

Cited by 5 publications

(15 citation statements)

References 14 publications

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“… 21 To date, few studies have specifically examined factors associated with discontinuation of care in HNC. 8 , 9 …”

Section: Discussionmentioning

confidence: 99%

“…This definition is similar to that used in another recent study of discontinuation of care in HNC. 9 Patients deceased at 365 days were excluded ( N = 50; 8.9%) and not considered part of the analytic sample for this study, therefore leaving a final N of 512; survival information was abstracted from the patient's medical record. Patients were considered cancer‐free if a cancer‐free status after curative‐intent treatment was confirmed during at least one visit approximately 90 days after treatment completion.…”

Section: Methodsmentioning

confidence: 99%

“… 3 , 6 , 7 However, a nontrivial number of patients may discontinue care soon after treatment, putting them at risk of negative outcomes. 8 , 9 …”

Section: Introductionmentioning

confidence: 99%

“… 10 , 12 One recent study found that only half of patients receive recommended surveillance testing over a 2‐year period posttreatment, for example. 12 Limited research to date suggests that factors such as marital status, treatment modality, and poor recognition of the recommended follow‐up period may be related to discontinuation in HNC, 8 , 9 but overall extremely little is known about those who discontinue follow‐up care. This includes rates of discontinuation and which key demographic, disease, and behavioral factors may play a role, thus warranting further investigation.…”

Section: Introductionmentioning

confidence: 99%

“…This is particularly true during the first year of the survivorship trajectory when side effects of treatment may be most obvious and risk of recurrence is increased 3,6,7 . However, a nontrivial number of patients may discontinue care soon after treatment, putting them at risk of negative outcomes 8,9 …”

Section: Introductionmentioning

confidence: 99%

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Examination of risk factors for discontinuation of follow‐up care in patients with head and neck cancer

2022

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Background Little research has examined discontinuation of follow‐up care in patients with head and neck cancer. This exploratory study sought to examine key demographic, disease, and behavioral factors as possible correlates of discontinuation ( N = 512). Methods Cross‐sectional study examined correlates of discontinuation of follow‐up care within 1 year. The primary outcome was defined as a disease‐free survivor not returning to cancer clinic for two consecutive follow‐up appointments within the first year of care and not reentering oncologic care at any point thereafter. Demographic, disease, and behavioral factors were examined using multivariable logistic regression. Results One hundred twenty‐six (24.6%) patients discontinued by 12‐month follow‐up. Being unmarried (OR = 1.28, 95% CI = 1.01–1.63, p = 0.041) and having elevated depressive symptomatology (OR = 1.04, 95% CI = 1.01–1.07, p = 0.034) were significantly associated with discontinuation. Receipt of a single (vs. multimodal) treatment approached significance (OR = 1.71, 95% CI = 0.96–3.07, p = 0.071). Conclusion Approximately one quarter of patients disengaged from important follow‐up care within 1 year. Lack of social support, depressive symptomatology, and single treatment modality may be important correlates of discontinuation of care in patients with head and neck cancer. Additional studies of this outcome are needed. Improved understanding of correlates associated with discontinuation could facilitate the identification of at‐risk patients and further development of interventions to keep patients engaged at a crucial time in the survivorship care trajectory.

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“… 21 To date, few studies have specifically examined factors associated with discontinuation of care in HNC. 8 , 9 …”

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“… 3 , 6 , 7 However, a nontrivial number of patients may discontinue care soon after treatment, putting them at risk of negative outcomes. 8 , 9 …”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Examination of risk factors for discontinuation of follow‐up care in patients with head and neck cancer

2022

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Examination of Predictors of Pain at 12 Months Postdiagnosis in Head and Neck Cancer Survivors

Howren,

Seaman,

Super

et al. 2023

Otolaryngol.--head neck surg.

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ObjectivePain following the completion of treatment is important but has received less attention in the head and neck cancer (HNC) literature. The present study sought to examine the prevalence and predictors of pain measured 12 months postdiagnosis and its impact on HNC‐specific health‐related quality of life (HRQOL) in 1038 HNC survivors.Study DesignProspective observational study.SettingSingle‐institution tertiary care center.MethodsPain was measured using a single item ranging from 0 to 10 with 0 representing no pain and 10 representing the worst pain possible. Self‐reported depressive symptomatology was measured using the Beck Depression Inventory and self‐reported problem alcohol use was measured by the Short Michigan Alcoholism Screening Test. HNC‐specific HRQOL was measured using the Head and Neck Cancer Inventory (HNCI).ResultsHierarchical multivariable linear regression analyses indicated that in addition to pain at 3 months postdiagnosis (β = .145, t = 3.18, sr2 = .019, p = .002), both depressive symptomatology (β = .110, t = 2.49, sr2 = .011, p = .015) and problem alcohol use (β = .092, t = 2.07, sr2 = .008, p = .039) were significant predictors of pain at 12 months postdiagnosis. Subgroup analyses suggest that across all 4 HNCI domains, those in the moderate and severe pain groups at 12 months postdiagnosis failed to reach 70 which is indicative of high functioning.ConclusionPain in patients with HNC is a considerable issue at 12 months postdiagnosis, deserving further attention. Behavioral factors such as depression and problem alcohol use may be associated with pain and require systematic screening over time to identify and treat issues that impact optimal long‐term recovery from HNC, including disease‐specific HRQOL.

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Prevalence of pain in a sample of long-term survivors of head and neck cancer

Howren,

Christensen,

Pagedar

2024

American Journal of Otolaryngology

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Assessment of conditions leading to lost-to-follow-up of head and neck cancer patients

Cited by 5 publications

References 14 publications

Examination of risk factors for discontinuation of follow‐up care in patients with head and neck cancer

Examination of risk factors for discontinuation of follow‐up care in patients with head and neck cancer

Examination of Predictors of Pain at 12 Months Postdiagnosis in Head and Neck Cancer Survivors

Prevalence of pain in a sample of long-term survivors of head and neck cancer

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