An assessment of patient burdens from head and neck cancer survivorship care

Rohde, Rebecca L.; Mckinstry, C.; Gresham, Malia; Osazuwa‐Peters, Nosayaba; Ward, Greg; Walker, Rebecca

doi:10.1016/j.oraloncology.2018.04.024

Cited by 18 publications

(45 citation statements)

References 37 publications

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“…No relevant studies were found in the search of the grey literature. After screening and full text review, 25 papers met the inclusion criteria and were included for analysis 6,11‐34 (Figure 3). A summary of the included studies is shown in Table 1.…”

Section: Resultsmentioning

confidence: 99%

The psychosocial cost burden of cancer: A systematic literature review

et al. 2020

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Background and Objective: Psychosocial costs, or quality of life costs, account for psychological distress, pain, suffering and other negative experiences associated with cancer. They contribute to the overall economic burden of cancer that patients experience. But this category of costs remains poorly understood. This hinders opportunities to make the best cancer control policy decisions. This study explored the psychosocial cost burden associated with cancer, how studies measure psychosocial costs and the impact of this burden. Methods: A systematic literature review of academic and grey literature published from 2008 to 2018 was conducted by searching electronic databases, guided by the Institute of Medicine's conceptualization of psychosocial burden. Results were analyzed using a narrative synthesis and a weighted proportion of populations affected was calculated. Study quality was assessed using the Ottawa-Newcastle instrument. Results: A total of 25 studies were included. There was variation in how psychosocial costs were conceptualized and an inconsistent approach to measurement. Most studies measured social dimensions and focused on the financial consequences of paying for care. Fewer studies assessed costs associated with the other domains of this burden, including psychological, physical, and spiritual dimensions. Fourty-four percent of cancer populations studied were impacted by psychosocial costs and this varied by disease site (38%-71%). Two studies monetized the psychosocial cost burden, estimating a lifetime cost per case ranging from CAD$427753 to CAD$528769. Studies were of varying quality; 60% of cross-sectional studies had a high risk of bias. Conclusions: Consistency in approach to measurement would help to elevate this issue for researchers and decision makers. At two-thirds of the total economic burden of cancer, economic evaluations should account for psychosocial costs to better inform decision-making. More support is needed to address the psychosocial cost burden faced by patients and their families.

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Section: Resultsmentioning

confidence: 99%

The psychosocial cost burden of cancer: A systematic literature review

et al. 2020

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“…In addition to the questions regarding the general perception of routine surveillance and preference for provider type, there were additional themes regularly mentioned. Other negative perceptions include the frequency of follow-up with 20% of patients feeling that appointments were too frequent and placed a significant burden on their life away from HNC survival 17,23 ; however, as previously discussed, in one study the majority are satisfied with the frequency of follow-up. 17 One study mentioned the focus of follow-up should be on the prevention of recurrence rather than 'surveillance'.…”

Section: Additional Themesmentioning

confidence: 90%

“…Fear of recurrence was highlighted in 11 studies as a source of anxiety. 10,11,12,13,15,17,18,19,20,21,22 Two studies found fear of recurrence to be particularly problematic early on in surveillance, 12,17 acting as a barrier to managing emotions surrounding cancer diagnoses. 24 Eleven publications reported unmet needs regarding the management of fear of recurrence (N = 1322).…”

Section: Fear Of Recurrencementioning

confidence: 99%

“…24 Eleven publications reported unmet needs regarding the management of fear of recurrence (N = 1322). 10,11,12,13,15,17,18,19,20,21,22 Breaking this down further, 1 study highlighted fear of recurrence as the top priority for patients during routine surveillance 11 and fear of recurrence lead to hypervigilance and reduced QoL. 20,21 3 of these 11 publications specifically reported that increased psychological support was necessary to deal with elements of survivorship and fear of recurrence 10,19,22 (N = 136).…”

Section: Fear Of Recurrencementioning

confidence: 99%

“…Patient preference for the healthcare professional-delivering surveillance was addressed in 6 studies. 10,17,18,22,23,24 3 of these showed a preference for routine follow-up to be performed by HNC nurse specialists 18,22,24 (N = 337, UK, ROI and USA). It was also reported that patients looked after by non-HNC-specialist nurses felt an increase in their unmet needs.…”

Section: Access To Appropriate Health Servicesmentioning

confidence: 99%

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Patient perspectives on surveillance after head and neck cancer treatment: A systematic review

McLaren

Perkins

Zhu

et al. 2021

Clinical Otolaryngology

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Head and neck cancer (HNC) is the sixth most common malignancy worldwide, 1 with 5-year survival rates in the United Kingdom (UK) reaching 67%. 2 A constant desire exists to improve healthcare delivery focusing on medical, functional and psychological needs. 3 Essential to the ongoing management of HNC survivors is routine surveillance. [4][5][6][7] In the UK, current recommendations include a multidisciplinary approach involving clinical assessment, nutritional support, repeated histological sampling and radiological assessment

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Quantifying Total and Out-of-Pocket Costs Associated With Head and Neck Cancer Survivorship

Chidambaram

Luong

Graboyes

et al. 2022

JAMA Otolaryngol Head Neck Surg

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ImportanceOncologic treatment is costly to the health care system and to individuals, but patients with head and neck cancer (HNC) also have long-term care needs after treatment. Survivors of HNC require specific consideration given their rapidly growing numbers. This subpopulation of cancer survivors often experiences long-term treatment-associated morbidity.ObjectiveTo describe the total and out-of-pocket (OOP) costs associated with HNC survivorship and the risk factors for financial toxicity among this population.Design, Setting, and ParticipantsThis was a retrospective review and economic evaluation of a cohort of US adults with a diagnosis of HNC from 2006 to 2018. The study used data the from IBM MarketScan Commercial Claims Database. Data were analyzed from November 2020 to June 2022.ExposuresTreatment for HNC.Main Outcomes and MeasuresTotal and OOP medical costs were assessed monthly and reported relative to the date of HNC diagnosis. The primary outcome was the difference between a patient’s mean monthly survivorship costs (13-60 months after diagnosis) and mean monthly baseline costs (7-12 months before diagnosis). Univariate and multivariable linear regression models were created for total and OOP costs to generate coefficient estimates with 95% CIs.ResultsThe study cohort of this economic evaluation included 19 098 patients with HNC (median [range] age, 56 [18-64] years; 14 144 [74.1%] men and 4954 [25.9%] women; race and ethnicity were not considered). Throughout the survivorship period, median total and OOP costs were $372 per month and $31 per month higher than baseline costs, respectively, with variation in expenses by demographic information, health plan type, and oncologic variables. In the multivariable model, greater total and OOP excess survivorship costs were associated with female sex ($343/mo; 95% CI, $126 to $560 and $9/mo; 95% CI, $4 to $14). Highest and lowest total excess survivorship costs associated with cancer site were seen for hypopharyngeal ($1908/mo; 95% CI, $1102 to $2714) and oropharyngeal cancers (−$703/mo; 95% CI, −$967 to −$439) vs oral cavity cancers. Compared with surgery or radiation therapy alone, multimodal treatment was generally associated with excess OOP survivorship costs.Conclusions and RelevanceThe findings of this retrospective economic evaluation review suggest that the costs of HNC survivorship remain persistently elevated above baseline costs for at least 5 years after diagnosis. High survivorship costs were associated with female sex, hypopharyngeal tumors, and treatment with multimodal therapy. Practitioners should seek to minimize costs for these patients at higher-risk of financial toxicity after treatment and work to provide directed supportive services.

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An assessment of patient burdens from head and neck cancer survivorship care

Cited by 18 publications

References 37 publications

The psychosocial cost burden of cancer: A systematic literature review

The psychosocial cost burden of cancer: A systematic literature review

Patient perspectives on surveillance after head and neck cancer treatment: A systematic review

Quantifying Total and Out-of-Pocket Costs Associated With Head and Neck Cancer Survivorship

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