VA Office of Rural Health (ORH), Veterans Rural Health Resource Center, Iowa City VA Health Care System, Iowa City, Iowa, USA.
Department of Behavioral Sciences & Social Medicine, College of Medicine, Florida State University, Tallahassee, Florida, USA.
Psychooncology. 2021 May;30(5):708-715. doi: 10.1002/pon.5616. Epub 2021 Jan 2.
Problem alcohol use in persons with head and neck cancer (HNC) is associated with poor outcomes, including survival. Some evidence suggests that individuals living in rural areas may be at greater risk of problem alcohol use. The present exploratory cross-sectional study sought to examine problem alcohol use at diagnosis in a sample of HNC patients by rural versus urban status.
Self-reported problem alcohol use as measured by the Short Michigan Alcoholism Screening Test (SMAST) was examined in rural and urban HNC patients at diagnosis (N = 454). Multivariable linear regression analysis was conducted to examine correlates of problem alcohol use. Subgroup analyses examined HNC-specific health-related quality of life (HRQOL) by problem drinking status at diagnosis and 3- and 12-month postdiagnosis in rural patients.
Multivariable linear regression analysis controlling for age, cancer site, cancer stage, depressive symptoms at diagnosis, and tobacco use at diagnosis indicated that rural residence was significantly associated with SMAST scores at diagnosis such that rural patients were more likely to report higher scores (ß = 0.095, sr = 0.010, p = 0.04). Covariate-adjusted subgroup analyses suggest that rural patients with self-reported problem alcohol use may exhibit deficits in HNC-specific HRQOL at diagnosis and 3- and 12-month postdiagnosis.
HNC patients should be screened for problem alcohol use at diagnosis and counseled regarding the deleterious effects of continued drinking during treatment and beyond. Because access to treatment and referral options may be lacking in rural areas, additional ways of connecting rural patients to specialty care should be explored.
有头颈部癌症（HNC）的人存在问题性饮酒与不良预后相关，包括生存情况。有证据表明，居住在农村地区的人可能面临更大的问题性饮酒风险。本探索性横断面研究旨在根据农村和城市地区来研究 HNC 患者诊断时的问题性饮酒情况。
通过短密歇根酒精筛查测试（SMAST），在诊断时对农村和城市 HNC 患者（n=454）的自我报告的问题性饮酒进行了检查。多变量线性回归分析用于检查问题性饮酒的相关性。亚组分析根据诊断时的饮酒问题和诊断后 3 个月和 12 个月的 HNC 特定健康相关生活质量（HRQOL），对农村患者进行了检查。
在控制年龄、癌症部位、癌症分期、诊断时的抑郁症状和诊断时的吸烟情况后，多变量线性回归分析表明，农村居住地与 SMAST 评分在诊断时显著相关，农村患者更有可能报告更高的分数（β=0.095，sr=0.010，p=0.04）。调整协变量的亚组分析表明，报告有自我饮酒问题的农村患者在诊断时以及诊断后 3 个月和 12 个月的 HNC 特异性 HRQOL 可能存在缺陷。
应在诊断时筛查 HNC 患者的问题性饮酒情况，并对其进行咨询，告知其在治疗期间及以后继续饮酒的有害影响。由于农村地区可能缺乏治疗和转诊选择，应探索其他方法将农村患者与专业护理联系起来。
