Problem alcohol use among rural head and neck cancer patients at diagnosis: Associations with health‐related quality of life

Howren, M. Bryant; Christensen, Alan J.; Adamowicz, Jenna L.; Seaman, Aaron; Wardyn, Shylo E.; Pagedar, Nitin A.

doi:10.1002/pon.5616

Cited by 11 publications

(14 citation statements)

References 39 publications

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“…Therefore, even when offered as part of comprehensive cancer care, consideration should be given to the existence of treatment options close to the patient if specialty treatment referral is in order and/or alternative modes of delivery for those services that are not nearby. Recent studies have shown rural-residing patients with HNC may be more likely to report problem drinking behavior and, of those, many exhibit at least mild to moderate depressive symptomatology [13,43]. This suggests that behavioral health connections may be especially valuable for this important subgroup.…”

Section: Discussionmentioning

confidence: 99%

“…Treatment modality was classified as surgery/chemotherapy/radiotherapy only, combination (i.e., multimodal), or other/unknown. Depressive symptoms were assessed using the Beck Depression Inventory (BDI), a widely utilized and well validated measure of depressive symptomatology with scores ranging from 0 to 63, which has been used in previous studies of HNC [11,13].…”

Section: Tobacco Use and Other Key Variablesmentioning

confidence: 99%

“…Patients with scores in the high category have relatively normal functioning, and those in the intermediate and low ranges have abnormal or severely compromised functioning, respectively. The HNCI has been used in many HNC studies [11][12][13] and has good reliability and validity [6].…”

Section: Health-related Quality Of Lifementioning

confidence: 99%

“…This trajectory does not hold for a substantial number of survivors, however, who remain markedly impaired in various HNC-specific HRQOL domains 1 year postdiagnosis [7,8]. Research indicates that this trajectory may be associated with numerous physical, psychosocial, and behavioral factors [7][8][9][10][11][12][13], thus making investigations of such factors important in order to identify which HRQOL domains require greater clinical attention over the course of treatment and recovery.…”

Section: Introductionmentioning

confidence: 99%

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Problem alcohol and tobacco use in head and neck cancer patients at diagnosis: associations with health-related quality of life

Howren

Christensen

Pagedar

2022

Support Care Cancer

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Purpose Problem alcohol and tobacco use in patients with head and neck cancer (HNC) frequently co-occur and each are associated with poor outcomes including health-related quality of life (HRQOL). The purpose of this descriptive exploratory study was to identify the prevalence of these co-occurring behaviors and associations with HNC-specific HRQOL within the first year of diagnosis in a large sample of patients with HNC. Methods Cross-sectional study examined prevalence of co-occurring problem alcohol and tobacco use at diagnosis in a large sample of patients with HNC (N = 1327). Problem alcohol use was assessed using the Short Michigan Alcoholism Screening Test (SMAST); patients were classified as current/previous/never smokers based on self-reported tobacco use. HNC-specific HRQOL was assessed using the Head and Neck Cancer Inventory (HNCI), measured at diagnosis and 3 and 12 months postdiagnosis. Results Three hundred twenty-five of 1327 (24.5%) scored 3 + on the SMAST at diagnosis, suggesting problem alcohol use and nearly 30% (28.4%) were current smokers. Of those with problem alcohol use, 173 (53.2%) were also current smokers. In total, 173 of 1327 (13.0%) exhibited both behaviors at diagnosis. Covariate-adjusted mean HNCI scores suggest that patients classified as both problem drinkers and current smokers have lower HRQOL scores during the first year postdiagnosis in multiple HNC-specific domains. Conclusion HNC patients should be screened for alcohol and tobacco use at diagnosis. Multimodal behavioral health interventions may provide one avenue for improved access and outcomes, particularly for patients at distance, and deserve further study in HNC.

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Section: Discussionmentioning

confidence: 99%

Section: Tobacco Use and Other Key Variablesmentioning

confidence: 99%

Section: Health-related Quality Of Lifementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Problem alcohol and tobacco use in head and neck cancer patients at diagnosis: associations with health-related quality of life

Howren

Christensen

Pagedar

2022

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“…Four studies were published on risk factors and prevalence. [66][67][68][69] A study of 1990 data by Schreinemachers et al 69 found a lower rate of oral cavity and larynx cancers in agricultural Minnesota, while newer studies 66,68 have demonstrated increasing rural incidence of head and neck cancers. Finally, 2 studies evaluated disparities in hospital outcomes of patients with head and neck cancer, with 1 study identifying lower costs and shorter length of stay in rural hospitals 70 but another study noting increased mortality for hospitalized patients with head and neck cancer.…”

Section: Head and Neck Cancermentioning

confidence: 99%

Rural Otolaryngology Care Disparities: A Scoping Review

Urban

Shimomura

Shah

et al. 2022

Otolaryngol.--head neck surg.

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Objective To broadly synthesize the literature regarding rural health disparities in otolaryngology, categorize findings, and identify research gaps to stimulate future work. Study Design Scoping review. Data Sources A comprehensive literature search was performed in the following databases: PubMed/MEDLINE, Scopus, Cochrane Central Register of Controlled Trials, Google Scholar, and CINAHL. Review Methods The methods were developed in concordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. Peer-reviewed, English-language, US-based studies examining a rural disparity in otolaryngology-related disease incidence, prevalence, diagnosis, treatment, or outcome were included. Descriptive studies, commentaries, reviews, and letters to the editor were excluded. Studies published prior to 1980 were excluded. Results The literature search resulted in 1536 unique abstracts and yielded 79 studies that met final criteria for inclusion. Seventy-five percent were published after 2010. The distribution of literature was as follows: otology (34.2%), head and neck cancer (20.3%), endocrine surgery (13.9%), rhinology and allergy (8.9%), trauma (5.1%), laryngology (3.8%), other pediatrics (2.5%), and adult sleep (1.3%). Studies on otolaryngology health care systems also accounted for 10.1%. The most common topics studied were practice patterns (41%) and epidemiology (27%), while the Southeast (47%) was the most common US region represented, and database study (42%) was the most common study design. Conclusion Overall, there was low-quality evidence with large gaps in the literature in all subspecialties, most notably facial plastic surgery, laryngology, adult sleep, and pediatrics. Importantly, there were few studies on intervention and zero studies on resident exposure to rural populations, which will be critical to making rural otolaryngology care more equitable in the future.

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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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Problem alcohol use among rural head and neck cancer patients at diagnosis: Associations with health‐related quality of life

Cited by 11 publications

References 39 publications

Problem alcohol and tobacco use in head and neck cancer patients at diagnosis: associations with health-related quality of life

Problem alcohol and tobacco use in head and neck cancer patients at diagnosis: associations with health-related quality of life

Rural Otolaryngology Care Disparities: A Scoping Review

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

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