Abstract
Oral cancer has a higher incidence in the lower social strata, and these patients are less likely to engage in supportive interventions and report a poorer quality of life (QoL). The aim of this paper is to compare the Patient Concerns Inventory (PCI) responses across social groups attending routine oral cancer follow-up clinics with particular focus on the deprivation lower quartile. The PCI package is completed by patients as part of their routine review consultation with SNR. Patients were those diagnosed between 2008 and 2012. Deprivation was stratified using the IMD 2010 from postcode. Of the 106 eligible patients, 85 % used the PCI. Just over half (54 %) were living in the most deprived quartile, with two-thirds (68 %) of males in the most deprived quartile, compared with 35 % of females (p = 0.004). In regard to number and type of PCI items selected by patients at their first PCI clinic, there were no notable differences in respect of IMD classification. The two commonest concerns were fear of recurrence (43 %) and sore mouth (43 %). The most deprived quartile reported significant problems in regard to mood (p = 0.004) and recreation (p = 0.02), and a non-significant trend (36 vs 18 %, p = 0.09) in stating their overall QoL as being less than good. It is possible to identify the concerns of patients from lower socioeconomic strata as part of routine follow-up clinics. This allows for targeted multi-professional intervention and supports to improve the outcome in this hard to reach group.
Highlights
Cancer affecting the head and neck is a condition which seriously impacts a number of areas of life, ranging from physical health to emotional wellbeing, both as a result of cancer and of treatment
Oral cancer has a higher incidence in the lower social strata, and these patients are less likely to engage in supportive interventions and report a poorer quality of life (QoL)
The rest of this paper focuses on these 87 patients and the relationship between indices of multiple deprivation (IMD) classification and first clinic use of Patient Concerns Inventory (PCI)/University of Washington Quality of Life questionnaire (UW-QOL)
Summary
Cancer affecting the head and neck is a condition which seriously impacts a number of areas of life, ranging from physical health to emotional wellbeing, both as a result of cancer and of treatment This results in the patient experiencing a number of concerns, such as trismus, fear of recurrence, issues with speech and feeding and xerostomia [1]. One measure of SES is indices of multiple deprivation (IMD) which is updated by the UK government every few years, and is comprised of income, employment, health, education, housing and services, living environment, and crime [7] This can be used in conjunction with an individual’s postcode to determine how deprived their area of residence is
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