Abstract
PurposeTo develop a European White Paper document on oropharyngeal dysphagia (OD) in head and neck cancer (HNC). There are wide variations in the management of OD associated with HNC across Europe.MethodsExperts in the management of specific aspects of OD in HNC across Europe were delegated by their professional medical and multidisciplinary societies to contribute to this document. Evidence is based on systematic reviews, consensus-based position statements, and expert opinion.ResultsTwenty-four sections on HNC-specific OD topics.ConclusionThis European White Paper summarizes current best practice on management of OD in HNC, providing recommendations to support patients and health professionals. The body of literature and its level of evidence on diagnostics and treatment for OD in HNC remain poor. This is in the context of an expected increase in the prevalence of OD due to HNC in the near future. Contributing factors to increased prevalence include aging of our European population (including HNC patients) and an increase in human papillomavirus (HPV) related cancer, despite the introduction of HPV vaccination in various countries. We recommend timely implementation of OD screening in HNC patients while emphasizing the need for robust scientific research on the treatment of OD in HNC. Meanwhile, its management remains a challenge for European professional associations and policymakers.
Highlights
The state of the art and minimum standards of oropharyngeal dysphagia (OD) care will vary by country across Europe and will depend on the setting of the medical care [acute hospital, Endorsed by the European Society for Swallowing Disorders (ESSD), the Confederation of European Otorhinolaryngology Head and Neck Surgery (CEORL-HNS), the European Head and Neck Society (EHNS), the Union of the European Phoniatricians (UEP), and the European Laryngological Society (ELS)
A section was supported by a systematic literature review and we aimed to provide an up-to-date overview of what we believe should be essential core knowledge for health professionals and what should be the minimum standard of care for OD in the head and neck cancer (HNC) setting
Coordination of a HNC multidisciplinary team (MDT) may be challenging [54], yet, despite its complexity, we argue that positive clinical, patient, and service outcomes can best be achieved through the implementation of a well-designed head and neck clinical pathway (HNCP) and MDT approach
Summary
The state of the art and minimum standards of oropharyngeal dysphagia (OD) care will vary by country across Europe and will depend on the setting of the medical care [acute hospital, Endorsed by the European Society for Swallowing Disorders (ESSD), the Confederation of European Otorhinolaryngology Head and Neck Surgery (CEORL-HNS), the European Head and Neck Society (EHNS), the Union of the European Phoniatricians (UEP), and the European Laryngological Society (ELS).Extended author information available on the last page of the article rehabilitation unit, community nursing home, speech-andlanguage pathologist (SLP) first-line practice, etc.], the cultural and religious background of the population, and the vision and resources available to policymakers. Tobacco is an important known risk factor for developing primary and relapsing HNC ("Etiology, epidemiology, and survival of head and neck cancer" section), patients need counseling and help to quit smoking.
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