The Head And Neck Cancer Patient Concern Inventory (C): Patient Concerns' Prevalence, Dental Concerns' Impact, And Relationships Of Concerns With Quality Of Life Measures

Purpose: The Patient Concern Inventory (c) (PCI) is a clinical tool of self-reported patient concerns to be used by the clinician to structure the patient-oncologist visit. It was developed in the United Kingdom to address the issues of quality of life (QOL) in head and neck cancer (HNC) patients. The purpose of the study reported here was to determine the prevalence of PCI (c) items, the associations between PCI (c) items and QOL, and to explore the importance of oral/dental issues in the patient's well-being.Methods: The PCI (c) and the University of Washington (UW-QOLv4) instruments were self-administered by an HNC population in a cross-sectional study. Following an a priori sample size estimate, consecutive HNC patients attending at the University of Florida's Oral Medicine and the ENT Clinics had the study described, eligibility assessed, and if eligible, were invited to participate in the study. Participants completed the PCI (c) and UW-QOL. PCI (c) issues prevalence was determined, and for those with a >= 10% prevalence: 1) Fisher's exact test was used to test for statistical differences between treatments, and 2) multivariable regression was used to test each of the prevalent PCI (c) issues across four QOL measures, health in the last 7 days, overall QOL in the last 7 days, and the physical and social domain scores.Results: Twenty of 45 PCI (c) issues had a prevalence >= 10%. Of the 15 prevalent items statistically associated with a QOL measure, four issues are the clinical responsibility of the dental profession: 1) chewing/eating, 2) dental health/teeth, 3) mouth opening, and 4) salivation. An additional four (eight total, 50%) are of clinical concern for dental clinicians: 5) pain in head/neck, 6) swallowing, 7) speech/voice/being understood, and 8) taste.Conclusions: Dental concerns represent almost half of all PCI (c) concerns observed in 10% or more of the sample patients. Prosthodontists should support our maxillofacial prosthodontics specialists in joining other oral oncologists and advocate for comprehensive, integrated dental support for HNC patients by assuring dental involvement/inclusion with the multidisciplinary oncology team and a research agenda to established best patient-centered outcomes.