Human papillomavirus and improvements in cancer therapy have contributed to a growing population of younger oropharyngeal cancer (OPC) survivors at risk of experiencing treatment-related adverse effects including taste problems. OPC patients experience both acute and chronic taste disorders with varying degrees of hypergeusia, dysgeusia, ageusia, and taste phantoms. These changes can negatively impact quality of life (QOL) and contribute to a decline in nutritional status and medication adherence. Factors associated with such taste disorders specific to OPC are not well characterized. The goal of this study was to investigate clinico-demographic risk factors associated with moderate to severe taste problems in long-term OPC survivors.
Methods: The study population included OPC survivors treated curatively at MD Anderson Cancer Center between January 2000 and December 2013 who responded to a cross-sectional survivorship survey. Taste symptoms were measured using a single item on the multi-symptom MD Anderson Symptom Inventory Head and Neck Cancer module (MDASI-HN). The MDASI-HN rates patient symptoms on a 0 (not present) to 10 (as bad as you can imagine) scale. Our primary outcome variable was patient-rated taste problems using the MDASI-HN, specifically dichotomized as moderate to severe (score ≥5) or none to mild (score <4). Descriptive statistics and multivariable logistic regression analysis were conducted to identify risk factors associated with moderate to severe taste problems.
Results: This study included 873 OPC survivors with a median survival time of 6.0 years (range 1-16 years). 142 (16.3%) reported moderate to severe taste problems and 731 (83.7%) reported none to mild taste problems. On multivariable analysis, age at diagnosis (OR 1.05; 95% CI, 1.02-1.07) and continued smoking at time of survey (OR 2.32; 95% CI: 1.00-5.39) were associated with increased risk, while a greater than high school education (OR 0.56; 95% CI, 0.35-0.92) and neck dissection (OR 0.37; 95% CI, 0.20-0.65) were associated with lower risk of moderate to severe taste problems.
Conclusion: In this large survivorship study, 1 out of 6 OPC survivors reported moderate to severe taste problems persisting years after treatment, with several factors associated with either increased or decreased risk. These results will inform prospective counseling by clinicians and future research into potential mechanisms underlying these associations as well as supportive care interventions to improve taste function and taste related QOL in OPC survivors.