State of survivorship in head and neck cancer: a national survey

Presentation: C132
Topic: Survivorship
Type: Poster
Date: Thursday, April 19, 2018
Session: 9:00 AM - 7:00 PM
Authors: David M Cognetti, MD1, Vikki M Villafor, MD2, Carole Fakhry, MD3, Matthew Miller, MD4, Kelly M Malloy, MD5
Institution(s): 1Sidney Kimmel Cancer Center at Thomas Jefferson University, 2Northwestern Medicine, Robert H Lurie Comprehensive Cancer Center of Northwestern University, 3Johns Hopkins Medicine, 4University of Rochester, 5University of Michigan

Importance: Cancer survivorship has become increasingly important as the Commission on Cancer (COC) of the American College of Surgeons (ACS) now mandates that providers offer survivors treatment summaries and survivorship care plans.  Its importance is further emphasized by the increasing number of long term survivors due to HPV-related oropharyngeal cancer.

Objective: To evaluate current knowledge and practices of head and neck oncologic surgeons with regard to survivorship.  

Design: A survey was developed by the American Head and Neck Society (AHNS) Survivorship Committee  and distributed to members of the AHNS electronically. Data were collected via SurveyMonkey.

Main Outcome(s) and Measure(s): The percentage of respondents who report practices in line with current survivorship recommendations

Results: The survey was distributed to 1403 AHNS members, with 202 responses (14.4%.) The majority of respondents were otolaryngologists (89.6%) and in academic practice (78.1%.) Most completed fellowship training (84.1%) and reported that >75% of their practice is dedicated to head and neck cancer care (62.4%.) The majority reported seeing patients after treatment at least every 3 months in the first year and for at least 5 years overall. Amongst survivorship topics, respondents were most likely to address detection of recurrence/second primary (97.5%), dysphagia (93.07%), and thyroid function (90.1%) with their patients; they were least likely to address sleep disturbance/apnea (27.7%) and body and self-image issues (29.7%.) The head and neck surgeon was reported as primarily responsible for survivorship care by 77.7% , and only 25.3 % had a dedicated head and neck survivorship clinic. Less than half provide patients with a written treatment summary (43.1%) or follow-up care plan (36.9%).

Conclusion: While close head and neck cancer surveillance regimens are practiced by essentially all respondents of the survey, formal survivorship clinics are rare and the majority are not providing written treatment summaries and survivorship care plans.  These results highlight the low adherence to COC recommendations by head and neck providers and the need for improved survivorship care planning. This represents a ripe opportunity for educational program development and survivorship research in head and neck cancer care.