Smoking and other health factors in patients with head and neck cancer

Kristen McCarter; Amanda L Baker; Luke Wolfenden; Chris Wratten; Judith Bauer; Alison K Beck; Erin Forbes; Gregory Carter; Lucy Leigh; Christopher Oldmeadow; Ben Britton

doi:10.1016/j.canep.2022.102202

Smoking and other health factors in patients with head and neck cancer

Cancer Epidemiol. 2022 Aug:79:102202. doi: 10.1016/j.canep.2022.102202. Epub 2022 Jun 21.

Authors

Affiliations

¹ School of Psychological Sciences, College of Engineering, Science and Environment, The University of Newcastle, Callaghan, New South Wales, Australia. Electronic address: Kristen.McCarter@newcastle.edu.au.
² School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia.
³ School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia; Department of Radiation Oncology, Calvary Mater Newcastle, Waratah, New South Wales, Australia.
⁴ Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University, Clayton, Victoria, Australia.
⁵ School of Psychology, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Australia.
⁶ CREDITSS-Clinical Research Design, Information Technology and Statistical Support Unit, Hunter Medical Research Institute, Newcastle, Australia.
⁷ School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia; CREDITSS-Clinical Research Design, Information Technology and Statistical Support Unit, Hunter Medical Research Institute, Newcastle, Australia.

PMID: 35749925
DOI: 10.1016/j.canep.2022.102202

Abstract

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 sub-group 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.

Keywords: Alcohol; Depression; Diet; Fatigue; Head and neck cancer; Physical activity; Smoking; Tobacco.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Alcohol Drinking / adverse effects
Alcohol Drinking / epidemiology
Fatigue / epidemiology
Fatigue / etiology
Head and Neck Neoplasms* / epidemiology
Head and Neck Neoplasms* / etiology
Head and Neck Neoplasms* / radiotherapy
Humans
Smoking* / adverse effects
Smoking* / epidemiology
Tobacco Smoking