Document Type

Conference Proceeding

Publication Date


Publication Title

Am J Clin Oncol


Background: Head and neck cancer (HNC) makes up about 3% of all cancers and is treated with systemic therapy, radiation, surgery, or a combination of these. HNC treatment can be associated with decreased patient reported health related quality of life (HR-QoL), which can lead to depression. The majority of studies found that females reported worse patient reported HR-QoL than males, however, there were a few that did not have a significant difference in overall patient reported QoL. With the discovery of patient oriented outcomes (PROs) in clinical practice affecting patient satisfaction, provider-patient relationship, and overall patient mortality, it is vital to include PROs in the creation of treatment plans.

Objectives: The objectives of this project are to highlight the differences in HR-QoL between men and women. Ultimately, using these PROs clinically will help to improve patient care, augment patient-provider trust, and optimize treatment plans. Using PROs and recognizing where unconscious biases of providers come into play is pinnacle, and this project aims to highlight how men and women's experiences are different in the treatment of HNC.

Methods: Participants were given the FACT-H&N instrument one year after treatment for head and neck cancer at a single tertiary academic center to assess different aspects of Hr-QoL. Sex differences were analyzed between the groups. A Wilcoxon Rank Sum test was performed to assess associations with sex and survey responses, as well as to assess associations with total laryngectomy and survey responses.

Results: There were 100 participants from a single academic center of which 73% were men and 27% women. Several of the questions had significant differences between men and women: "I feel ill (P=0.0299)," "I am satisfied with my family communication about my illness P=0.0075)," "I am satisfied with my sex life (P=0.0496)," "My voice has its usual quality and strength (P=0.0057)," "I can swallow naturally and easily (P=0.0437)," and "I can eat solid foods (P=0.0248)." There were no significant differences between men and women with laryngectomies.

Conclusions: Overall, men felt more ill, were less satisfied with their sex lives, were less likely to feel a normal strength and quality of voice, felt decreased ability to swallow normally, and felt they could not eat solid foods; women were less satisfied with communication about their disease to their families. For those who had undergone laryngectomy, there were no significant differences between men and women. Different aspects of quality of life for men and women are affected by head and neck cancer. Monitoring PROs are becoming increasingly standard of care for patients, and providers need to be equipped understand how to interpret data accordingly and understand the inherent biases.





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