Abstract
<h3>Purpose/Objective(s)</h3> Cross-sectional studies show many unmet needs in patients with head and neck cancer (HNC); prospective studies are lacking. Our purpose was to determine the number, type, and predictors at baseline of unmet needs over time. <h3>Materials/Methods</h3> Patients with non-metastatic HNC were enrolled prior to curative treatment. Demographics, the Cancer Survivors' Unmet Needs (CaSUN), Functional Assessment of Cancer Therapy (FACT-HN) and EuroQol 5D (EQ-5D) were collected at baseline, 3-, 6-, 12- and 24-months post-treatment. Mean unmet needs at each timepoint and predictors for number of unmet needs were identified. <h3>Results</h3> Of 197 patients (median age 64, 80% male), 153 (78%) completed questionnaires at baseline, 126 (64%) at 3, 104 (53%) at 6, 103 (52%) at 12 and 97 (49%) at 24 months. Education was beyond high school in 118 (60%) and 85% had internet access. Most patients had oropharynx (n=88; 46%) and hypopharynx/larynx (n=45; 24%) cancer. The mean number of unmet needs at baseline, 3, 6, 12 and 24 months was: 7.5 ± 9.1, 3.8 ± 6, 5.3 ± 8.4, 2.9 ± 5.8 and 2.8 ± 6.5 respectively. At least one unmet need was reported at these timepoints by 68%, 52%, 56%, 41% and 39% of patients. The mean FACT-HN scores were 110.7 ± 21.6, 109.4 ± 21.9, 108.3 ± 22.9, 117.1 ± 20.5 and 118 ± 22.3 respectively, while the mean EQ-5D VAS scores were 72 ± 20.5, 73.3 ± 17.3, 75.9 ± 15.5, 79 ± 15.6 and 78.2 ± 15. The top 3 needs at baseline, 6, 12 and 24 months are shown in Table 1; qualitative change was seen. Multivariable analysis showed that education greater than high school (p < 0.01), living alone (p = 0.02), cancers of the lip and oral cavity (p < 0.01) and lower baseline FACT HN scores (p < 0.001) were associated with increased unmet needs at baseline. Having no computer access (p < 0.01), being a never smoker (p = 0.036) and lower baseline FACT HN scores (p = 0.03) are associated with increased unmet needs at 24 months. <h3>Conclusion</h3> HNC patients' unmet needs decrease and change over time. Survivorship resources are needed that serve different issues through the cancer journey.
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