Changes in unmet needs after treatment for head and neck cancers – A prospective longitudinal cohort study

Abstract

Objectives

This study aimed to assess changes in unmet needs among patients with head and neck cancer (HNC) from pre-treatment to two years post-treatment and identify factors associated with higher levels of unmet needs.

Materials & Methods

Patients treated for HNC at Princess Margaret Cancer Centre between June 2016 and February 2019 were recruited. Participants completed the Cancer Survivors’ Unmet Needs Measure Questionnaire (CaSUN), the Functional Assessment of Cancer Therapy − Head and Neck (FACT-HN) questionnaire, and the EuroQol EQ-5D-5L utility and Visual Analog Scale (EQ-5D-5L and VAS) pre-treatment and at 3, 6, 12, and 24-months post-treatment.

Results

Among 332 eligible patients approached, 197 were included. Significant reductions in number of unmet needs were observed between baseline and all follow-ups: 48 % fall at 3 months (p < 0.001), 39 % at 6 (p = 0.001), 54 % at 12 (p < 0.001), and 59 % at 24 months (p < 0.001). Higher education (p = 0.018, RR 1.88 [95 % CI 1.1–3.1]) and lower baseline FACT-HN & EQ-5D-5L VAS scores (p < 0.001, RR 0.98 [95 % CI 0.96–0.99] & p = 0.02, RR 0.99 [95 % CI 0.97–1 respectively]) were associated with higher unmet needs pre-treatment. Younger age (p = 0.041, RR 0.95 [95 %C I 0.9–1]) and lower baseline FACT-HN scores (p = 0.028, RR 0.97 [95 % CI 0.95–1]) were associated with higher unmet needs at 24 months.

Conclusions

Patients with HNC experience unmet needs, but the number declines from pre-treatment to two years post-treatment. Younger age, higher educational level, lower baseline FACT HN and EQ-5D-5L scores were associated with higher levels of unmet needs at various follow-up stages.