1
|
Einarsson S, Bokström A, Laurell G, Tiblom Ehrsson Y. Mapping the impact of malnutrition as defined by the Global Leadership Initiative on Malnutrition and nutrition impact symptoms on the possibility of returning to work after treatment for head and neck cancer. Support Care Cancer 2023; 32:55. [PMID: 38133825 PMCID: PMC10746764 DOI: 10.1007/s00520-023-08252-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 12/08/2023] [Indexed: 12/23/2023]
Abstract
PURPOSE This study aimed to investigate whether malnutrition or nutrition impact symptoms (NIS) affect the possibility of returning to work after treatment for head and neck cancer. METHODS Patients of working age with head and neck cancer were followed up from treatment initiation to 3 months (n = 238), 1 year (n = 182), and 2 years (n = 130) after treatment completion. The observed decrease in the number of patients over time was due to retirement, lack of follow-up, or death. Returning to work was dichotomised as yes or no. Malnutrition was diagnosed 7 weeks after treatment initiation using the Global Leadership Initiative on Malnutrition (GLIM) criteria. This time-point corresponds to the end of chemoradiotherapy or radiotherapy (with or without prior surgery), except for patients who underwent exclusive surgery. NIS were scored on a Likert scale (1-5) at each follow-up using the Head and Neck Patient Symptom Checklist© (HNSC©). Nonparametric tests were used to analyse the ability of patients with/without malnutrition and high/low NIS scores to return to work. RESULTS At 3 months, 1 year, and 2 years after treatment completion, 135/238 (56.7%), 49/182 (26.9%), and 23/130 (17.7%) patients had not returned to work. Patients with malnutrition at 7 weeks after treatment initiation were more likely to not return to work at 3 months than those without malnutrition, 70.5% compared to 47.1% (p < 0.001). At all three follow-up time-points, patients reporting high scores for a number of NIS had more often not returned to work, with this pattern being most distinct at 2 years. CONCLUSION Malnutrition according to the GLIM criteria at 7 weeks after treatment initiation and NIS assessed by the HNSC© at subsequent follow-ups were predictors of the return-to-work process after treatment for up to 2 years. TRIAL REGISTRATION NUMBER ClinicalTrials.gov NCT03343236 (date of registration 17/11/2017).
Collapse
Affiliation(s)
- Sandra Einarsson
- Department of Food, Nutrition and Culinary Science, Umeå University, Umeå, Sweden.
| | - Anna Bokström
- Unit for Celiac Disease and Diabetes, Lund University, Department of Pediatrics, Skåne University Hospital, Malmö, Sweden
| | - Göran Laurell
- Department of Surgical Sciences, Section of Otorhinolaryngology and Head & Neck Surgery, Uppsala University, Uppsala, Sweden
| | - Ylva Tiblom Ehrsson
- Department of Surgical Sciences, Section of Otorhinolaryngology and Head & Neck Surgery, Uppsala University, Uppsala, Sweden
| |
Collapse
|
2
|
Demanelis K, Rosenzweig M, Robertson LB, Low CA, Daniels S, Abujaradeh H, Simon B, Bovbjerg DH, Diergaarde B. Impact of the COVID-19 pandemic on cancer patients in western Pennsylvania: rural-urban disparities. Cancer Causes Control 2023; 34:595-609. [PMID: 37129763 PMCID: PMC10153039 DOI: 10.1007/s10552-023-01696-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 03/31/2023] [Indexed: 05/03/2023]
Abstract
PURPOSE Disparities in cancer care persist between patients living in rural versus urban areas. The COVID-19 pandemic may have impacted concerns related to care and personal health differently in rural cancer patients. Using survey data collected from cancer patients in western Pennsylvania, we examined pandemic-related distress, concerns related to cancer care, impact on personal health, and the extent to which these differed by urban-rural residence. METHODS Patients filled out an initial survey in August-December 2020; a second survey was completed in March 2021. The following patient concerns related to the pandemic were evaluated: threat of COVID-19 to their health, pandemic-related distress, perceptions of cancer care, and vaccine hesitancy. Multivariable logistic regression models were used to examine relationships between these outcomes and urban-rural residence as well as patient-related factors, including anxiety symptoms and social support. RESULTS The study sample included 1,980 patients, 17% resided in rural areas. COVID-19 represented a major or catastrophic threat to personal health for 39.7% of rural and 49.0% of urban patients (p = 0.0017). Patients with high general anxiety were 10-times more likely to experience pandemic-related distress (p < 0.001). In the follow-up survey (n = 983), vaccine hesitancy was twice as prevalent among rural patients compared to urban (p = 0.012). CONCLUSIONS The extent to which perceptions of the threat of COVD-19 to personal health and vaccine hesitancy exacerbates rural-urban disparities in cancer care and prognosis warrants further study. Cancer patients may be vulnerable to heightened anxiety and distress triggered by the pandemic.
Collapse
Affiliation(s)
- Kathryn Demanelis
- School of Medicine, Department of Medicine, Division of Hematology/Oncology, University of Pittsburgh, Pittsburgh, PA, USA.
- UPMC Hillman Cancer Center, 5114 Centre Ave, Pittsburgh, PA, 15232, USA.
| | - Margaret Rosenzweig
- UPMC Hillman Cancer Center, 5114 Centre Ave, Pittsburgh, PA, 15232, USA
- School of Nursing, Department of Acute and Tertiary Care, University of Pittsburgh, Pittsburgh, PA, USA
| | - Linda B Robertson
- School of Medicine, Department of Medicine, Division of Hematology/Oncology, University of Pittsburgh, Pittsburgh, PA, USA
- UPMC Hillman Cancer Center, 5114 Centre Ave, Pittsburgh, PA, 15232, USA
| | - Carissa A Low
- School of Medicine, Department of Medicine, Division of Hematology/Oncology, University of Pittsburgh, Pittsburgh, PA, USA
- UPMC Hillman Cancer Center, 5114 Centre Ave, Pittsburgh, PA, 15232, USA
| | - Shayla Daniels
- School of Nursing, Department of Acute and Tertiary Care, University of Pittsburgh, Pittsburgh, PA, USA
| | - Hiba Abujaradeh
- School of Nursing, Department of Acute and Tertiary Care, University of Pittsburgh, Pittsburgh, PA, USA
| | - Beth Simon
- UPMC Hillman Cancer Center, 5114 Centre Ave, Pittsburgh, PA, 15232, USA
| | - Dana H Bovbjerg
- UPMC Hillman Cancer Center, 5114 Centre Ave, Pittsburgh, PA, 15232, USA
- School of Medicine, Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Brenda Diergaarde
- UPMC Hillman Cancer Center, 5114 Centre Ave, Pittsburgh, PA, 15232, USA
- School of Public Health, Department of Human Genetics, University of Pittsburgh, Pittsburgh, PA, USA
| |
Collapse
|