Journal
CANCER EPIDEMIOLOGY
Volume 79, Issue -, Pages -Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.canep.2022.102202
Keywords
Head and neck cancer; Smoking; Tobacco; Alcohol; Physical activity; Diet; Fatigue; Depression
Funding
- National Health and Medical Research Council [NHMRC] [APP1021018, 2011/3654]
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This study investigates patterns of smoking and other health factors in head and neck cancer patients throughout treatment, follow-up, and survivorship. Results show increased rates of smoking and hazardous alcohol use post radiotherapy, as well as common occurrence of fatigue and unhealthy behaviors in long-term follow-up. These findings suggest the need for intervention beyond treatment to improve long-term health outcomes in patients.
Background: Information on smoking and other health factors in head and neck cancer (HNC) patients throughout treatment, follow-up and survivorship is limited. This study explores patterns of multiple health factors during radiotherapy (RT) and naturalistic long-term follow-up in a convenience sample of patients with HNC. Methods: Smoking, alcohol use and depression were measured at baseline, 4 and 12 weeks post RT for a subgroup of 99 patients who participated in a randomised controlled trial and completed long-term follow-up. These factors plus healthy eating, physical activity and fatigue are also reported from the long-term follow-up component. Smoking was measured by self-report and biochemically, whilst all other variables were by self report. Where variables were assessed at multiple time points logistic mixed effects regression models determined within-person changes over time. Results: There were important discrepancies between self-reported (4-;7%) and biochemically verified (13-29%) rates of smoking. Rates of smoking and hazardous alcohol intake were significantly increased at follow-up compared to baseline. Depression rates were observed to be higher at end of RT compared to baseline. At long-term follow-up, fatigue was common and co-occurred with suboptimal healthy eating and hazardous alcohol use. Conclusion: Clinically important levels of smoking and alcohol consumption post RT in this sample suggest possible targets for intervention beyond treatment into long-term follow-up of patients.
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