Disparities in adherence to head and neck cancer follow-up guidelines

Haley K. Perlow, Stephen J. Ramey, Vincent Cassidy, Deukwoo Kwon, Benjamin Farnia, Elizabeth Nicolli, Michael A. Samuels, Laura Freedman, Nagy Elsayyad, Raphael Yechieli, Stuart E. Samuels

Research output: Contribution to journalArticle

Abstract

Objectives: In this study, we aim to determine the frequency of adherence to National Comprehensive Cancer Network follow-up guidelines in a population of head and neck cancer patients who received curative treatment. We will also assess the impact of race, ethnicity, socioeconomic status, and treatment setting on utilization of follow-up care. Methods: This study included patients with biopsy-proven, nonmetastatic oropharyngeal or laryngeal cancer treated with radiotherapy between January 1, 2014, and June 30, 2016, at a safety-net hospital or adjacent private academic hospital. Components of follow-up care analyzed included an appointment with a surgeon or radiation oncologist within 3 months and posttreatment imaging of the primary site within 6 months. Univariable and multivariable analyses were conducted using a logistic regression model to estimate odds ratios and corresponding 95% confidence intervals. Results: Two hundred and thirty-four patients were included in this study. Of those, 88.8% received posttreatment imaging of the primary site within 6 months; 88.5% attended a follow-up appointment with a radiation oncologist within 3 months; and 71.1% of patients attended a follow-up appointment with a surgeon within 3 months. On multivariable analysis, private academic hospital treatment versus safety-net hospital treatment was associated with increased utilization of both surgical and radiation oncology follow-up. Non-Hispanic black (NHB) patients, Hispanic patients, and those with a low socioeconomic status were also less likely to receive follow-up. Conclusion: Safety-net hospital treatment, socioeconomic status, Hispanic ethnicity, and NHB race were associated with decreased follow-up service utilization. Quality improvement initiatives are needed to reduce these disparities. Level of Evidence: 2b. Laryngoscope, 2018.

Original languageEnglish (US)
JournalLaryngoscope
DOIs
StateAccepted/In press - Jan 1 2018

Keywords

  • follow-up care
  • Head and neck cancer
  • healthcare disparities
  • Hispanic

ASJC Scopus subject areas

  • Otorhinolaryngology

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    Perlow, H. K., Ramey, S. J., Cassidy, V., Kwon, D., Farnia, B., Nicolli, E., Samuels, M. A., Freedman, L., Elsayyad, N., Yechieli, R., & Samuels, S. E. (Accepted/In press). Disparities in adherence to head and neck cancer follow-up guidelines. Laryngoscope. https://doi.org/10.1002/lary.27676