Swallowing Disparities In Oropharyngeal Squamous Cell Carcinoma (Opscc)
Posted Date: Jan 31, 2023
- Investigator: David Rule
- Specialties: Cancer, Head and Neck Cancer, Otolaryngology, Radiation Oncology, Speech Pathology
- Type of Study: Observational/Survey
Given known sociodemographic and economic disparities within the United States healthcare system (Albain et al., 2009), we believe that clearly identifying these factors in patients with OPSCC will greatly improve clinical ability to identify and rectify disparities to ensure equitable, quality care. Male patients from ethnic minorities, particularly black men, show increased head and neck cancer mortality, followed by patients from rural populations, patients with mental illness, and patients from low-income backgrounds. These factors are important as frequent visits with a speech-language pathologist in a swallowing therapy setting can help improve swallowing function and swallowing-related quality of life. Finally, socioeconomic, and demographic determinants of health like insurance status, awareness of HNC risk, and societal mistrust of healthcare also play potential roles in swallowing outcomes given patients’ ability to pay for services, or present for services at all. Specifically concerning OPSCC, African American males have higher incidence and are known to present at later stages of diagnosis (III and IV). Additionally, individuals who lack insurance or have Medicaid coverage are at greater risk of presenting with advanced OPSCC stages. The stage of diagnosis is associated with decreased swallowing function given that large lesions impact more anatomical structures, cause increasing pain, and disrupt normal muscular function in the oropharynx. Therefore, we expect to identify disparities in swallowing function in OPSCC as a function of sociodemographic factors. Identifying and characterizing disparities enables appropriate action planning through interventions such as swallowing rehabilitation, policy development to optimize financial resources for vulnerable/at-risk populations, and interventions to improve survivor/caregiver coping and quality of life. Long-term side effects can be managed effectively with adequate access to appropriate rehabilitative care; thus, disparities in outcomes must be addressed. Focusing on oropharyngeal cancer where swallowing dysfunction is known to occur will ultimately inform care for all patients with HNC from initial diagnosis through the end of life. There are personal/social, societal, and economic burdens associated with chronic swallowing dysfunction, and addressing these upstream factors ensures equitable care for all patients.
Criteria:
Participants Are Eligible If They Are Adults, After An Initial Oropharyngeal Squamous Cell Carcinoma Diagnosis, After Initial Treatment Or Combination Of Treatments (E.G. Surgery, Radiation, Chemotherapy).
Keywords:
Dysphagia, Disparities, Cancer
For More Information:
David Rule
513-558-1719
ruledw@ucmail.uc.edu