Unmet supportive care needs among head and neck cancer survivors beyond 5 years after diagnosis: a multinational cohort study.

Abstract

This study investigates unmet supportive care needs (SCNs) among head and neck cancer (HNC) survivors beyond 5 years after diagnosis and examines the association with sociodemographic, clinical and lifestyle factors, and differences in European and non-European regions and healthcare systems. In this cross-sectional study, 1097 HNC survivors from 11 countries completed the Short-Form Supportive Care Needs Survey (SCNS-SF34) and HNC-specific module (SCNS-HNC), encompassing physical and daily living, psychological, sexuality, HNC-specific and lifestyle domains. Scores were dichotomized per domain and across domains into moderate-high unmet SCNs (yes/no). Logistic regression analyses were used to investigate associated factors. Half (50%, proportion 100/200) of HNC survivors had unmet SCNs (overall), especially unmet HNC-specific (40%, 40/100), psychological (25%, 25/100), and physical and daily living (22%, 22/100) needs. Personal (women, lower age), lifestyle (smoking, alcohol consumption) and clinical factors (advanced tumor stage, second primary tumor, multimodality treatment [versus single surgery], poor Karnofsky performance score and comorbidities) were associated with unmet SCNs. Physical and daily living, HNC-specific and overall unmet SCNs were more likely among survivors from Northern Europe compared to Southern and Western Europe. Unmet psychological, sexuality and lifestyle needs were more likely among non-European countries. All unmet SCNs (except psychological) were more likely among survivors with a national health system compared to a social and/or etatist health insurance system. Half of HNC survivors have unmet SCNs. Insight into healthcare utilization may provide insights how to improve care. European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Group.