Owoc Maryanna S, Carlson Katie M, Nilsen Marci Lee, Mowery Yvonne M, Contrera Kevin J, Hetrick Jennifer, Osazuwa-Peters Nosayaba, Zandberg Dan P, Stinnett Sandra, Johnson Jonas T, Mazul Angela L
Department of Otolaryngology - Head and Neck Surgery, University of Pittsburgh Medical Center, 203 Lothrop St # 500, Pittsburgh, PA, 15213, USA.
Cancer Epidemiology and Prevention Program, UPMC Hillman Cancer Center, 5115 Centre Ave, Pittsburgh, PA, 15232, USA.
J Cancer Surviv. 2025 Sep 8. doi: 10.1007/s11764-025-01878-2.
Despite its importance, little is known about the patterns and predictors of Survivorship Clinic attendance in head and neck cancer (HNC). We sought to determine the cumulative incidence of Survivorship Clinic attendance stratified by demographic, clinical, and socioeconomic factors, and to identify factors independently associated with attendance.
Our analysis population consisted of 2,252 patients diagnosed with primary HNC and seen at our institution's HNC Survivorship Clinic after completing treatment from 2016-2021. Factors associated with increased likelihood of attending the Survivorship Clinic post-treatment, within five years of diagnosis, were identified using Cox proportional hazards regression.
The overall cumulative incidence of Survivorship Clinic attendance reached 47.5% (95% confidence interval [CI]: 44.3-50.5%). Greater distance from clinic ((30-60 miles] hazard ratio [HR]: 0.58, 95% CI: 0.44-0.76, and > 60 miles HR: 0.46, 95% CI: 0.34-0.62) was independently associated with decreased likelihood of attendance. Factors independently associated with increased likelihood of attendance were stage III (HR: 1.47, 95% CI: 1.11-1.95) or IV (HR: 1.54, 95% CI: 1.15-2.05) cancer and treatment with radiotherapy (HR: 2.78, 95% CI: 2.12-3.64).
Less than half of our cohort attended the Survivorship Clinic post-treatment, within the first five years of diagnosis. Clinical factors, including disease stage and treatment modality, and social determinants, including distance from the clinic, were independently associated with Survivorship Clinic attendance.
These findings underscore the need for targeted interventions to increase access to survivorship care in HNC.
尽管其很重要，但对于头颈癌（HNC）患者参加生存诊所的模式及预测因素了解甚少。我们试图确定按人口统计学、临床和社会经济因素分层的生存诊所就诊累积发生率，并识别与就诊独立相关的因素。
我们的分析人群包括2252例被诊断为原发性头颈癌且于2016年至2021年在本院完成治疗后到本院头颈癌生存诊所就诊的患者。采用Cox比例风险回归分析确定在诊断后五年内治疗后参加生存诊所可能性增加的相关因素。
生存诊所就诊的总体累积发生率达到47.5%（95%置信区间[CI]：44.3 - 50.5%）。与诊所距离更远（30 - 60英里，风险比[HR]：0.58，95% CI：0.44 - 0.76；大于60英里，HR：0.46，95% CI：0.34 - 0.62）与就诊可能性降低独立相关。与就诊可能性增加独立相关的因素包括III期（HR：1.47，95% CI：1.11 - 1.95）或IV期（HR：1.54，95% CI：1.15 - 2.05）癌症以及接受放射治疗（HR：2.78，95% CI：2.12 - 3.64）。
在我们的队列中，不到一半的患者在诊断后的前五年内治疗后参加了生存诊所。临床因素，包括疾病分期和治疗方式，以及社会决定因素，包括与诊所的距离，与生存诊所就诊独立相关。
这些发现强调了需要采取有针对性的干预措施，以增加头颈癌患者获得生存护理的机会。
