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Laryngoscope. 2017 Jan;127(1):127-133. doi: 10.1002/lary.26159. Epub 2016 Jul 9.

Smoking status and symptom burden in surgical head and neck cancer patients.

Author information

1
Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina.
2
Department of Psychiatry and Behavioral Sciences and Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina.
3
Department of Biostatistical Sciences and Comprehensive Cancer Center of Wake Forest University, Wake Forest School of Medicine, Winston-Salem, North Carolina.
4
Department of Otolaryngology-Head and Neck Surgery and Comprehensive Cancer Center of Wake Forest University, Wake Forest School of Medicine, Winston-Salem, North Carolina.
5
Department of Radiation Oncology and Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina.
6
Department of Otolaryngology-Head and Neck Surgery and Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina.
7
Department of Social Sciences and Health Policy and Comprehensive Cancer Center of Wake Forest University, Wake Forest School of Medicine, Winston-Salem, North Carolina, U.S.A.

Abstract

OBJECTIVES/HYPOTHESIS:

Head and neck squamous cell carcinoma (HNSCC) patients who smoke are at risk for poor treatment outcomes. This study evaluated symptom burden and clinical, sociodemographic, and psychosocial factors associated with smoking in surgical patients to identify potential targets for supportive care services.

STUDY DESIGN:

Cross-sectional survey.

METHODS:

Individuals with HNSCC of the oral cavity, larynx, or pharynx were recruited from two cancer centers and completed questionnaires assessing smoking status (never, former, current/recent), patient characteristics, and symptoms before surgery.

RESULTS:

Of the 103 patients enrolled, 73% were male, 52% were stage IV, 41% reported current/recent smoking, and 37% reported former smoking. Current/recent smokers were less likely than former smokers to have adequate finances (53% vs. 89%, P = .001) and be married/partnered (55% vs. 79%, P = .03). Current/recent smokers were also more likely than both former and never smokers to be unemployed (49% vs. 40% and 13%, respectively, all P = .02) and lack health insurance (17% vs. 5% and 13%, respectively, all P ≤.04). Fatalistic beliefs (P = .03) and lower religiosity (P =.04) were more common in current/recent than never smokers. In models adjusted for sociodemographic/clinical factors, current/recent smokers reported more problems than former and never smokers with swallowing, speech, and cough (P ≤.04). Current/recent smokers also reported more problems than never smokers with social contact, feeling ill, and weight loss (P ≤ .02).

CONCLUSIONS:

HNSCC patients reporting current/recent smoking before surgery have high-risk clinical and sociodemographic features that may predispose them to poor postoperative outcomes. Unique symptoms in HNSCC smokers may be useful targets for patient-centered clinical monitoring and intervention.

LEVEL OF EVIDENCE:

4 Laryngoscope, 127:127-133, 2017.

KEYWORDS:

Head and neck cancer; cigarette smoking; oral cancer; surgery; symptoms; tobacco

PMID:
27392821
PMCID:
PMC5177454
DOI:
10.1002/lary.26159
[Indexed for MEDLINE]
Free PMC Article

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