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Schellack S, Breidenbach C, Rick O, Kowalski C. Predictive factors for return to work among cancer survivors in Europe: a systematic review. Crit Rev Oncol Hematol 2024:104422. [PMID: 38897312 DOI: 10.1016/j.critrevonc.2024.104422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 06/13/2024] [Accepted: 06/14/2024] [Indexed: 06/21/2024] Open
Abstract
Of the 4.4 million people diagnosed with cancer in Europe each year, around 36% are of working age. Return-to-work rates vary across Europe. Work is important for the individual, as well as for society, and this review aims to provide an overview of the predictors for the return to work (RTW) process in European cancer survivors of working age. A systematic literature search was conducted. The present review included quantitative and qualitative study designs published since 2013. In total, the review included 85 papers examining cancer survivors with various cancer diagnoses in 18 European countries. Identified predictive factors for RTW related to the social system, treatment, disease, health behavior, the individuals' psychosocial, work, and sociodemographic situations. There is a need for a standardized definition and operationalization of RTW. Providers can use these results to identify survivors at risk and support cancer survivors in their RTW process.
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Affiliation(s)
- Sophie Schellack
- German Cancer Society, Kuno-Fischer-Straße 8, 14057 Berlin, Germany.
| | | | - Oliver Rick
- Center for Oncology Rehabilitation, Clinic Reinhardshoehe, Quellenstraße 8-12, 34537 Bad Wildungen, Germany
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Zhang Y, Wang Y, Wu A, Tao X, Li M, Yan D, Wen F, Hou L. The Prevalence and Determinants of Return to Work in Head and Neck Cancer Survivors: A Scoping Review. JOURNAL OF OCCUPATIONAL REHABILITATION 2023; 33:418-431. [PMID: 36689058 DOI: 10.1007/s10926-022-10090-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/06/2022] [Indexed: 06/17/2023]
Affiliation(s)
- Yuanyuan Zhang
- Shanghai JiaoTong University School of Nursing, No.227 South Chongqing Road, Shanghai, China
| | - Yueping Wang
- Shanghai JiaoTong University School of Medicine Affiliated Ninth People's Hospital, No.639 Zhizaoju Road, Shanghai, China
| | - Anqi Wu
- Shanghai JiaoTong University School of Nursing, No.227 South Chongqing Road, Shanghai, China
- Shanghai JiaoTong University School of Medicine Affiliated Shanghai Children ' s Medical Center, No.1678 Dongfang Road, Shanghai, China
| | - Xingjuan Tao
- Shanghai JiaoTong University School of Nursing, No.227 South Chongqing Road, Shanghai, China
| | - Mengyao Li
- Shanghai JiaoTong University School of Nursing, No.227 South Chongqing Road, Shanghai, China
| | - Dexiu Yan
- Shanghai JiaoTong University School of Nursing, No.227 South Chongqing Road, Shanghai, China
| | - Fule Wen
- Shanghai JiaoTong University School of Nursing, No.227 South Chongqing Road, Shanghai, China
| | - Lili Hou
- Shanghai JiaoTong University School of Nursing, No.227 South Chongqing Road, Shanghai, China.
- Shanghai JiaoTong University School of Medicine Affiliated Ninth People's Hospital, No.639 Zhizaoju Road, Shanghai, China.
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Yu J, Smith J, Marwah R, Edkins O. Return to work in patients with head and neck cancer: Systematic review and meta-analysis. Head Neck 2022; 44:2904-2924. [PMID: 36121026 PMCID: PMC9826518 DOI: 10.1002/hed.27197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 08/05/2022] [Accepted: 08/31/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The aim of this review was to determine the prevalence of return to work (RTW) amongst head and neck cancer (HNC) survivors and to determine its impact on quality of life (QoL). METHODS A literature search was conducted in PubMed, Scopus, Embase and CINAHL in March 2021. Articles were included if they reported the number of patients with HNC receiving definitive treatment who were working at the time of diagnosis and returned to work. RESULTS There were 21 articles deemed eligible for inclusion. Meta-analysis suggested that 67% of patients with HNC who were employed at diagnosis RTW (95% CI 62%-73%, I2 = 97.53%). Patients who RTW were demonstrated to have lower levels of anxiety and depressive symptoms on the Hospital Anxiety and Depression Scale. CONCLUSIONS Return to work is an important clinical outcome which must be considered in the survivorship care of patients with HNC.
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Affiliation(s)
- Justin Yu
- Townsville University HospitalTownsvilleQueenslandAustralia,Faculty of Medicine and HealthThe University of SydneyCamperdownNew South WalesAustralia
| | - Justin Smith
- Townsville University HospitalTownsvilleQueenslandAustralia,James Cook UniversityCollege of Medicine and DentistryTownsvilleAustralia
| | - Ravi Marwah
- Townsville University HospitalTownsvilleQueenslandAustralia,James Cook UniversityCollege of Medicine and DentistryTownsvilleAustralia
| | - Oskar Edkins
- Townsville University HospitalTownsvilleQueenslandAustralia
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Gurgel do Amaral GS, Ots P, Brouwer S, van Zon SKR. Multimorbidity and exit from paid employment: the effect of specific combinations of chronic health conditions. Eur J Public Health 2022; 32:392-397. [PMID: 35253841 PMCID: PMC9159305 DOI: 10.1093/eurpub/ckac018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background This study aimed to assess the association between multimorbidity and exit from paid employment, and which combinations of chronic health conditions (CHCs) have the strongest association with exit from paid employment. Methods Data from 111 208 workers aged 18–64 years from Lifelines were enriched with monthly employment data from Statistics Netherlands. Exit from paid employment during follow-up was defined as a change from paid employment to unemployment, disability benefits, economic inactivity or early retirement. CHCs included cardiovascular diseases (CVD), chronic obstructive pulmonary disease (COPD), rheumatoid arthritis (RA), type 2 diabetes (T2DM) and depression. Cox-proportional hazards models were used to examine the impact of multimorbidity and combinations of CHCs on exit from paid employment. Results Multimorbidity increased the risk of exiting paid employment compared with workers without CHCs (hazard ratio (HR): 1.52; 95% confidence interval (CI): 1.35–1.71) or one CHC (HR: 1.14; 95% CI: 1.01–1.28). The risk for exit from paid employment increased among workers with COPD if they additionally had CVD (HR: 1.39; 95% CI: 1.03–1.88), depression (HR: 1.46; 95% CI: 1.10–1.93) or RA (HR: 1.44; 95% CI: 1.08–1.91), for workers with T2DM if they additionally had CVD (HR: 1.43; 95% CI: 1.07–1.91) or depression (HR: 2.09; 95% CI: 1.51–2.91) and for workers with depression who also had T2DM (HR: 1.68; 95% CI: 1.21–2.32). Conclusion This study showed that workers with multimorbidity, especially having a combination of COPD and depression or T2DM and depression, have a higher risk for early exit from paid employment and, therefore, may need tailored support at the workplace.
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Affiliation(s)
- Gabriel S Gurgel do Amaral
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Patricia Ots
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Sandra Brouwer
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Sander K R van Zon
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Abstract
PURPOSE OF REVIEW There is a lack of evidence worldwide on return to work (RTW) in head and neck cancer (HNC), possibly because traditionally those suffering with it were typically at retirement age and survival rates were low. However, in the last 30 years, HNC survival rates have increased, resulting in more people living with the after-effects of treatment for longer, and many are of working-age. The HNC population is also changing because of a 20% increased incidence of oral and pharyngeal HNCs especially in the under 65 years of age, likely accounted for by the surge in human papilloma virus positive related HNCs. RECENT FINDINGS The literature suggests that people who have had treatment for HNC return to work less than other cancers. The knowledge base on RTW after HNC is emergent and conclusions are currently difficult to draw. The process of returning and remaining in work is complex, affected by multiple factors and interactions. There is little evidence about work-related experiences from the perspectives of HNC survivors. SUMMARY There is an urgent need for more in-depth exploration of the needs and concerns of HNC survivors returning to work after treatment, with the ultimate aim of work-related intervention development.
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van Zon SKR, Reijneveld SA, Galaurchi A, Mendes de Leon CF, Almansa J, Bültmann U. Multimorbidity and the Transition Out of Full-Time Paid Employment: A Longitudinal Analysis of the Health and Retirement Study. J Gerontol B Psychol Sci Soc Sci 2020; 75:705-715. [PMID: 31083712 PMCID: PMC7768699 DOI: 10.1093/geronb/gbz061] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Indexed: 12/30/2022] Open
Abstract
Objectives This study aims to examine whether older workers aged 50–64 years with multimorbidity are at increased risk to transition from full-time paid employment to part-time employment, partial retirement, unemployment, disability, economic inactivity, full retirement or die than workers without a chronic health condition and workers with one chronic health condition, and whether socioeconomic position (SEP) modifies these transitions. Method Using data from the Health and Retirement Study (1992–2014; n = 10,719), sub-distribution hazard ratios with 95% confidence intervals were calculated with a time-varying Fine and Gray competing-risks survival regression model to examine exit from full-time paid employment. We investigated the modifying effect of SEP by examining its interaction with multimorbidity. Results Workers with multimorbidity had a higher risk of transitioning to partial retirement (1.45; 1.22, 1.72), disability (1.84; 1.21, 2.78) and full retirement (1.63; 1.47, 1.81), and they had a higher mortality risk (2.58; 1.71, 3.88) than workers without chronic disorders. Compared to workers with one chronic health condition, workers with multimorbidity had an increased risk for partial (1.19; 1.02, 1.40) and full retirement (1.29; 1.17, 1.42), and mortality (1.49; 1.09, 2.04). Only SEP measured as educational level modified the relationship between multimorbidity and mortality. Discussion Workers with multimorbidity seem more prone to leave full-time paid employment than workers without or with one a chronic health condition. Personalized work accommodations may be necessary to help workers with multimorbidity prolong their working life.
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Affiliation(s)
- Sander K R van Zon
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Sijmen A Reijneveld
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Anne Galaurchi
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, The Netherlands
| | | | - Josué Almansa
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Ute Bültmann
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, The Netherlands
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Granström B, Tiblom Ehrsson Y, Holmberg E, Hammerlid E, Beran M, Tano K, Laurell G. Return to work after oropharyngeal cancer treatment-Highlighting a growing working-age population. Head Neck 2020; 42:1893-1901. [PMID: 32092226 DOI: 10.1002/hed.26123] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 01/17/2020] [Accepted: 02/11/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND To describe the frequency of patients returning to work after treatment for oropharyngeal cancer and to identify predictors and physical barriers that might interfere with the return to work process. METHODS Cross-sectional study including 295 patients. Data were collected regarding work/sick leave situation at 1 month before diagnosis and 15 months after diagnosis. The situation before diagnosis was retrospectively recalled by the patients. Two subscales and two single items from the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-H&N35 were used. Data were analyzed with multivariate logistic regression. RESULTS Fifteen months after diagnosis, 212 patients (72%) were working. To be working 15 months after diagnosis was associated with working before diagnosis. Swallowing difficulties, problems talking on the telephone, and physical appearance were negatively associated with returning to work. CONCLUSIONS The large number of individuals returning to work is encouraging for patients diagnosed with oropharyngeal cancer.
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Affiliation(s)
- Brith Granström
- Department of Clinical Science, Unit of Otorhinolaryngology, Umeå University, Umeå, Sweden
| | - Ylva Tiblom Ehrsson
- Department of Surgical Sciences, Section of Otorhinolaryngology and Head & Neck Surgery, Uppsala University, Uppsala, Sweden
| | - Erik Holmberg
- Region Västra Götaland, Regional Cancer Centre West, Gothenburg, Sweden, and Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Eva Hammerlid
- Department of Otorhinolaryngology-Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Martin Beran
- Department of ENT and Maxillofacial Surgery, NAL Medical Center Hospital, Trollhättan, Sweden
| | - Krister Tano
- Department of Clinical Science/ENT/Sunderby Research Unit, Umeå University, Umeå, Sweden
| | - Göran Laurell
- Department of Surgical Sciences, Section of Otorhinolaryngology and Head & Neck Surgery, Uppsala University, Uppsala, Sweden
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Lai YC, Tang PL, Chu CH, Kuo TJ. Effects of income and residential area on survival of patients with head and neck cancers following radiotherapy: working age individuals in Taiwan. PeerJ 2018; 6:e5591. [PMID: 30245932 PMCID: PMC6147123 DOI: 10.7717/peerj.5591] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 08/16/2018] [Indexed: 01/29/2023] Open
Abstract
Objectives The five-year survival rate of head and neck cancer (HNC) after radiotherapy (RT) varies widely from 35% to 89%. Many studies have addressed the effect of socioeconomic status and urban dwelling on the survival of HNC, but a limited number of studies have focused on the survival rate of HNC patients after RT. Materials and methods During the period of 2000–2013, 40,985 working age individuals (20 < age < 65 years) with HNC patients treated with RT were included in this study from a registry of patients with catastrophic illnesses maintained by the Taiwan National Health Insurance Research Database (NHIRD). Results The cumulative survival rate of HNC following RT in Taiwan was 53.2% (mean follow-up period, 3.75 ± 3.31 years). The combined effects of income and geographic effect on cumulative survival rates were as follows: high income group > medium income group > low income group and northern > central > southern > eastern Taiwan. Patients with moderate income levels had a 36.9% higher risk of mortality as compared with patients with high income levels (hazard ratio (HR) = 1.369; p < 0.001). Patients with low income levels had a 51.4% greater risk of mortality than patients with high income levels (HR = 1.514, p < 0.001). Conclusion In Taiwan, income and residential area significantly affected the survival rate of HNC patients receiving RT. The highest income level group had the best survival rate, regardless of the geographic area. The difference in survival between the low and high income groups was still pronounced in more deprived areas.
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Affiliation(s)
- Yu Cheng Lai
- Department of Orthopedics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Department of Marine Biotechnology and Resources, National Sun Yat-Sen University, Kaohsiung, Taiwan.,Department of Occupational Therapy, Shu Zen junior College of Medicine and Management, Kaohsiung, Taiwan
| | - Pei Ling Tang
- Research Center of Medical Informatics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Department of Nursing, Meiho University, Pingtung, Taiwan.,College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chi Hsiang Chu
- Department of Clinical Trial Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Tsu Jen Kuo
- Department of Marine Biotechnology and Resources, National Sun Yat-Sen University, Kaohsiung, Taiwan.,Department of Dental Technology, Shu-Zen junior College of Medicine and Management, Kaohsiung, Taiwan.,Department of Stomatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
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Graber JM, Chuang CT, Ward CL, Black K, Udasin IG. Head and Neck Cancer in World Trade Center Responders: A Case Series. J Occup Environ Med 2018; 60:e439-e444. [PMID: 29933317 PMCID: PMC6131053 DOI: 10.1097/jom.0000000000001386] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to report on cases of head and neck cancer (HNC) among World Trade Center (WTC) responders participating in the WTC Health Program and seen at Rutgers WTC Center of Clinical Excellence. METHODS Medical records were abstracted by two clinical reviewers and discrepancies resolved. Cases were defined as WTC responders diagnosed with HNC between December 9, 2005, and December 31, 2016. RESULTS Sixteen HNC patients met the case definition, most (13) arrived at the WTC location on 9/11 or within the following 2 days, and half worked in law enforcement during the 9/1 response. CONCLUSION An association between HNC and WTC exposure is biologically plausible and should be further investigated. Research to enumerate the risk factor profile for these cancers may contribute to understanding mechanisms by which WTC exposure can contribute to carcinogenesis and to prevention and early detection strategies.
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Affiliation(s)
- Judith M Graber
- Rutgers, The State University of New Jersey, School of Public Health, Department of Epidemiology, Piscataway, New Jersey (Dr Graber); Rutgers, The State University of New Jersey, School of Public Health, Department of Environmental and Occupational Health, Piscataway, New Jersey (Dr Chuang); Rutgers Robert Wood Johnson Medical School, Department of Medicine, Piscataway, New Jersey (Dr Ward); Rutgers The State University of New Jersey, Environmental and Occupational Health Sciences Institute (EOHSI), Clinical Research and Occupational Medicine, Piscataway, New Jersey (Dr Black); Rutgers The State University of New Jersey, School of Public Health, Department of Environmental and Occupational Health, EOHSI Clinical Center, Piscataway, New Jersey (Dr Udasin)
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Lee YH, Chang KH, Escorpizo R, Chi WC, Yen CF, Liao HF, Huang SW, Liou TH. Accuracy of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) score as an objective assessment tool for predicting return-to-work status after head and neck cancer in male survivors. Support Care Cancer 2018; 27:433-441. [DOI: 10.1007/s00520-018-4322-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 06/18/2018] [Indexed: 10/28/2022]
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Bschorer M, Schneider D, Hennig M, Frank B, Schön G, Heiland M, Bschorer R. Early intensive rehabilitation after oral cancer treatment. J Craniomaxillofac Surg 2018; 46:1019-1026. [PMID: 29709327 DOI: 10.1016/j.jcms.2018.04.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2017] [Revised: 03/21/2018] [Accepted: 04/04/2018] [Indexed: 10/17/2022] Open
Abstract
PURPOSE The treatment of oral cancer requires an effective rehabilitation strategy such as an early intensive rehabilitation (EIR) program. MATERIALS AND METHODS The medical records and data of 41 patients who participated in an EIR program and 20 control group patients were analyzed. These patients all underwent surgical resection of the primary tumor followed by microsurgical reconstruction using free flaps. The length of stay (LOS) at the acute care hospital was compared between the two groups. Four indexes were used to evaluate the effectiveness of the EIR program. RESULTS EIR patients stayed an average of 11.6 fewer days at the acute care hospital. All indexes showed significant improvements (p < 0.001). The Barthel Index (BI) and the Early Intensive Rehabilitation Barthel Index (EIR-BI) improved by 36.0 and 103.6 points, respectively. At discharge, the Bogenhausener Dysphagia Score (BODS) had improved to a score of 11.0 compared to the 13.9 at admission. EIR patients had a Work Ability Index (WAI) score of 25.7. CONCLUSION Length of stay at the acute care hospital can be reduced using early intensive rehabilitation if patients are transferred to an intensive rehabilitation clinic early.
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Affiliation(s)
| | - Daniel Schneider
- Department of Oral and Maxillofacial Surgery, HELIOS Kliniken Schwerin, Germany
| | - Matthias Hennig
- Department of Oral and Maxillofacial Surgery, HELIOS Kliniken Schwerin, Germany
| | - Bernd Frank
- Clinic for Early Rehabilitation and Interdisciplinary Rehabilitation Center, HELIOS Klinik Leezen, Germany
| | - Gerhard Schön
- Department of Medical Biometry and Epidemiology, Universitätsklinikum Hamburg-Eppendorf, Germany
| | - Max Heiland
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Reinhard Bschorer
- Department of Oral and Maxillofacial Surgery, HELIOS Kliniken Schwerin, Germany.
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Abstract
AIM OF THE DATABASE The Danish Head and Neck Cancer database is a nationwide clinical quality database that contains prospective data collected since the early 1960s. The overall aim of this study was to describe the outcome of the national strategy for multidisciplinary treatment of head and neck cancer in Denmark and to create a basis for clinical trials. STUDY POPULATION The study population consisted of all Danish patients referred for treatment of squamous cell carcinoma of the larynx, pharynx, oral cavity, or neck nodes from unknown primary or any histopathological type (except lymphoma) of cancer in the nasal sinuses, salivary glands, or thyroid gland (corresponding to the International Classification of Diseases, tenth revision, classifications C.01-C.11, C.30-C.32, C.73, and C.80). MAIN VARIABLES The main variables used in the study were symptoms and the duration of the symptoms; etiological factors; pretreatment and diagnostic evaluation, including tumor-node-metastasis classification, imaging, histopathology, and laboratory tests; primary treatment with semidetailed information of radiotherapy, surgery, and medical treatment; follow-up registration of tumor status and side effects; registration of relapse and treatment thereof; and registration of death and cause of death. MAIN RESULTS Data from >33,000 patients have been recorded during a period of >45 years. In this period, the outcome of treatment improved substantially, partly due to better treatment as a result of a series of continuous clinical trials and subsequent implementation in national guidelines. The database has furthermore been used to describe the effect of reduced waiting time, changed epidemiology, and influence of comorbidity and socioeconomic parameters. CONCLUSION Half a century of registration of head and neck cancer treatment and outcome has created the basis for understanding and has substantially contributed to improve the treatment of head and neck cancer at both national and international levels.
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Affiliation(s)
- Jens Overgaard
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus
| | - Aleksandar Jovanovic
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus
| | - Christian Godballe
- Department of ORL - Head and Neck Surgery; Department of Oncology, Odense University Hospital, Odense, Denmark
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Early and late physical and psychosocial effects of primary surgery in patients with oral and oropharyngeal cancers: a systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 121:583-94. [DOI: 10.1016/j.oooo.2015.12.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Revised: 11/23/2015] [Accepted: 12/21/2015] [Indexed: 11/21/2022]
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Murphy BA, Deng J. Advances in Supportive Care for Late Effects of Head and Neck Cancer. J Clin Oncol 2015; 33:3314-21. [PMID: 26351334 DOI: 10.1200/jco.2015.61.3836] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
As the population of head and neck cancer survivors increases, it has become increasingly important for health care providers to understand and manage late complications of therapy. Functional deficits can be categorized as general health deficits resulting in frailty or debility, head and neck-specific functional deficits such as swallowing and speech, and musculoskeletal impairment as a result of tumor and treatment. Of critical importance is the growing data indicating that swallow therapy and physical therapy may prevent or ameliorate long-term functional deficits. Oral health complications of head and neck therapy may manifest months or years after the completion of treatment. Patients with hyposalivation are at high risk for dental caries and thus require aggressive oral hygiene regimens and routine dental surveillance. Swallowing abnormalities, xerostomia, and poor dentition may result in dietary adaptations that may cause nutritional deficiencies. Identification and management of maladaptive dietary strategies are important for long-term health. Follow-up with primary care physicians for management of comorbidities such as diabetes and hyperlipidemia may help to limit late vascular complications caused by radiation therapy. Herein, we review late effects of head and neck cancer therapy, highlighting recent advances.
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Affiliation(s)
- Barbara A Murphy
- Barbara A. Murphy, Vanderbilt-Ingram Cancer Center; and Jie Deng, School of Nursing, Vanderbilt University, Nashville, TN.
| | - Jie Deng
- Barbara A. Murphy, Vanderbilt-Ingram Cancer Center; and Jie Deng, School of Nursing, Vanderbilt University, Nashville, TN
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Re: Impact of comorbidity in staging & management decision making of nasopharyngeal Ca (NPC). Radiother Oncol 2015; 115:435. [PMID: 25981131 DOI: 10.1016/j.radonc.2015.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Accepted: 04/29/2015] [Indexed: 11/21/2022]
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Olsen MH, Bøje CR, Kjær TK, Steding-Jessen M, Johansen C, Overgaard J, Dalton SO. Socioeconomic position and stage at diagnosis of head and neck cancer - a nationwide study from DAHANCA. Acta Oncol 2015; 54:759-66. [PMID: 25734503 DOI: 10.3109/0284186x.2014.998279] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Socioeconomic differences in survival after head and neck squamous cell carcinoma (HNSCC) are among the greatest for any malignancy. To improve our understanding of the mechanisms by which socioeconomic position influences HNSCC survival, we investigated the association between socioeconomic position and advanced stage HNSCC at diagnosis. MATERIAL AND METHODS Men and women with HNSCC diagnosed between 1992 and 2008 were identified in the Danish Head and Neck Cancer Group (DAHANCA) database, which contains detailed information on all cases of HNSCC treated in Denmark. Individual information on the following four socioeconomic indicators: highest attained educational level, cohabitation status, disposable income and degree of urbanisation were obtained from Statistics Denmark. For the 9683 cases on which there was full information, we estimated odds ratios (ORs) for a diagnosis of advanced stage (TNM III-IV) HNSCC in multivariate logistic regression models by site (glottic, non-glottic larynx, oropharynx, hypopharynx and oral cancer), with adjustment for age, gender, period of diagnosis, education, income, cohabitation status, degree of urbanisation and comorbidity in accordance with a causal diagram. RESULTS For all HNSCC sites, the ORs for advanced stage at diagnosis were increased for patients with low income and for men living alone. For glottic and oral cancers, the ORs for advanced stage HNSCC increased systematically by decreasing length of education. Increased ORs were found for hypopharynx cancer patients living in rural areas or provincial cities. Having one or more comorbid conditions was associated with an increased OR for advanced stage oral cancer but with a decreased OR for oropharynx cancer. CONCLUSION In this nationwide population-based study, socioeconomic differences in stage at diagnosis were found for all HNSCC subsites. Focus on the high risk for advanced stage HNSCC among vulnerable patients may be beneficial during referral and diagnosis in order to improve HNSCC outcomes.
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Affiliation(s)
- Maja Halgren Olsen
- Survivorship, Danish Cancer Society Reseach Center , Copenhagen , Denmark
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Horsboel TA, Nielsen CV, Andersen NT, Nielsen B, de Thurah A. Risk of disability pension for patients diagnosed with haematological malignancies: a register-based cohort study. Acta Oncol 2014; 53:724-34. [PMID: 24456498 DOI: 10.3109/0284186x.2013.875625] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
UNLABELLED Patients with haematological malignancies are at increased risk of experiencing work-related problems. The aims of this study were to compare the risk of disability pension (DP) among patients diagnosed with eight subtypes of haematological malignancies to a reference cohort, and to determine if relative risks differ between these subtypes; to evaluate the influence of socioeconomic factors, demographic factors, and clinical factors on the risk of DP; and to investigate if these associations differ between the reference cohort and the patient cohort. MATERIAL AND METHODS We combined data from national registers on Danish patients diagnosed with haematological malignancies between 2000 and 2007 and a reference cohort without a history of these diseases. A total of 3194 patients and 28 627 reference individuals were followed until DP, emigration, old age pension or anticipatory pension, death or 26 February 2012, whichever came first. RESULTS A total of 550 (17%) patients and 1511 (5%) reference individuals were granted DP. Age- and gender-adjusted relative risks differed significantly between the subgroups of haematological malignancies and ranged from 2.64 (95% CI 1.84-3.78) for patients with Hodgkin lymphoma to 12.53 (95% CI 10.57-14.85) for patients with multiple myeloma. In the patient cohort we found that gender, age, comorbidity, ethnicity, educational level, household income, history of long-term sick leave, and need of treatment with anxiolytics or antidepressants after diagnosis were associated with receiving DP. However, most of these associations were stronger in the reference cohort. CONCLUSION All eight subtypes of haematological malignancies were associated with an increased risk of DP compared to the reference cohort. The relative risks differed according to subtype, and patients with multiple myeloma had the highest risk of DP. Furthermore, most socioeconomic, demographic and clinical factors had a stronger impact on the risk of DP in the reference cohort than in the patient cohort.
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Bøje CR. Impact of comorbidity on treatment outcome in head and neck squamous cell carcinoma – A systematic review. Radiother Oncol 2014; 110:81-90. [DOI: 10.1016/j.radonc.2013.07.005] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Revised: 07/14/2013] [Accepted: 07/15/2013] [Indexed: 10/26/2022]
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