Distress levels in patients with oropharyngeal vs. non-oropharyngeal squamous cell carcinomas of the head and neck over 1 year after diagnosis: a retrospective cohort study

Support Care Cancer. 2017 Oct;25(10):3225-3233. doi: 10.1007/s00520-017-3733-5. Epub 2017 Jun 10.

Abstract

Background: Human papillomavirus (HPV)-related cancers have been associated with different demographic profiles and disease characteristics than HPV-unrelated cancers in head and neck patients, but distress and other symptoms have not been compared. The aim of this study was to assess whether distress levels, fatigue, pain, anxiety, depression, and common psychological and practical problems differ between head and neck cancer patients with HPV-related vs. HPV-unrelated carcinomas (using oropharyngeal carcinoma (OPC) and non-OPC cancers as surrogates for HPV status).

Methods: Distress, depression, anxiety, fatigue, pain, and common problems were examined in 56 OPC and 90 non-OPC patients at 4 timepoints during the first year following diagnosis. Two-level hierarchical linear modeling was used to examine effects.

Results: The HPV-related OPC group was more likely to be younger (p = 0.05), Caucasian (p = 0.001), non-smokers (p = 0.01), earn more (p = 0.04), and present with more advanced stage (p < 0.0001). At baseline, OPC patients reported only higher pain scores (p = 0.01) than non-OPC patients. Total problems decreased more in the OPC group (p = 0.08) than the non-OPC group from baseline to 12-month follow-up. In both groups, scores on distress, depression, psychosocial problems, and practical problems decreased similarly over time.

Conclusions: Despite a difference in the clinico-demographic characteristics of HPV-related vs. HPV-unrelated patients, only baseline pain levels and total problems over time differed between the two groups.

Keywords: Distress; Head and neck cancer; Health-related quality of life; Human papillomavirus; Oropharyngeal; Psychosocial oncology.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / epidemiology
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / psychology*
  • Female
  • Head and Neck Neoplasms / complications
  • Head and Neck Neoplasms / epidemiology
  • Head and Neck Neoplasms / pathology
  • Head and Neck Neoplasms / psychology*
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Oropharyngeal Neoplasms / epidemiology
  • Oropharyngeal Neoplasms / pathology
  • Oropharyngeal Neoplasms / psychology*
  • Papillomaviridae / physiology
  • Papillomavirus Infections / complications
  • Papillomavirus Infections / epidemiology
  • Papillomavirus Infections / psychology
  • Retrospective Studies
  • Severity of Illness Index
  • Stress, Psychological / epidemiology*
  • Stress, Psychological / pathology
  • Young Adult