Premium
Disparities in adherence to head and neck cancer follow‐up guidelines
Author(s) -
Perlow Haley K.,
Ramey Stephen J.,
Cassidy Vincent,
Kwon Deukwoo,
Farnia Benjamin,
Nicolli Elizabeth,
Samuels Michael A.,
Freedman Laura,
Elsayyad Nagy,
Yechieli Raphael,
Samuels Stuart E.
Publication year - 2019
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.27676
Subject(s) - medicine , socioeconomic status , odds ratio , radiation therapy , head and neck cancer , confidence interval , radiation oncologist , cancer , logistic regression , population , surgery , physical therapy , environmental health
Objectives In this study, we aim to determine the frequency of adherence to National Comprehensive Cancer Network follow‐up guidelines in a population of head and neck cancer patients who received curative treatment. We will also assess the impact of race, ethnicity, socioeconomic status, and treatment setting on utilization of follow‐up care. Methods This study included patients with biopsy‐proven, nonmetastatic oropharyngeal or laryngeal cancer treated with radiotherapy between January 1, 2014, and June 30, 2016, at a safety‐net hospital or adjacent private academic hospital. Components of follow‐up care analyzed included an appointment with a surgeon or radiation oncologist within 3 months and posttreatment imaging of the primary site within 6 months. Univariable and multivariable analyses were conducted using a logistic regression model to estimate odds ratios and corresponding 95% confidence intervals. Results Two hundred and thirty‐four patients were included in this study. Of those, 88.8% received posttreatment imaging of the primary site within 6 months; 88.5% attended a follow‐up appointment with a radiation oncologist within 3 months; and 71.1% of patients attended a follow‐up appointment with a surgeon within 3 months. On multivariable analysis, private academic hospital treatment versus safety‐net hospital treatment was associated with increased utilization of both surgical and radiation oncology follow‐up. Non‐Hispanic black (NHB) patients, Hispanic patients, and those with a low socioeconomic status were also less likely to receive follow‐up. Conclusion Safety‐net hospital treatment, socioeconomic status, Hispanic ethnicity, and NHB race were associated with decreased follow‐up service utilization. Quality improvement initiatives are needed to reduce these disparities. Level of Evidence 2b Laryngoscope , 129:2303–2308, 2019