Neck Cancer Diagnosis Research Articles

Artificial Intelligence in Head and Neck Cancer Diagnosis: A Comprehensive Review with Emphasis on Radiomics, Histopathological, and Molecular Applications.

The present review discusses the transformative role of AI in the diagnosis and management of head and neck cancers (HNCs). Methods: It explores how AI technologies, including ML, DL, and CNNs, are applied in various diagnostic tasks, such as medical imaging, molecular profiling, and predictive modeling. Results: This review highlights AI's ability to improve diagnostic accuracy and efficiency, particularly in analyzing medical images like CT, MRI, and PET scans, where AI sometimes outperforms human radiologists. This paper also emphasizes AI's application in histopathology, where algorithms assist in whole-slide image (WSI) analysis, tumor-infiltrating lymphocytes (TILs) quantification, and tumor segmentation. AI shows promise in identifying subtle or rare histopathological patterns and enhancing the precision of tumor grading and treatment planning. Furthermore, the integration of AI with molecular and genomic data aids in mutation analysis, prognosis, and personalized treatment strategies. Conclusions: Despite these advancements, the review identifies challenges in AI adoption, such as data standardization and model interpretability, and calls for further research to fully integrate AI into clinical practice for improved patient outcomes.

Managing Postoperative Delirium in Patients Receiving Head and Neck Surgery: An Educational Overview.

Postoperative delirium in patients receiving head and neck surgery is a pressing concern, affecting morbidity, mortality, and healthcare costs. With an aging population and about 65,000 new head and neck cancer diagnoses per year in the United States, surgery remains a primary treatment modality, regardless of age. This article offers an educational overview of postoperative delirium management in patients receiving head and neck surgery, summarizing incidence, etiology, pathophysiology, diagnostic tests, treatment, complications, and risk factors. A narrative literature review of articles published in the past 10 years was conducted to consolidate information on postoperative delirium in patients receiving head and neck surgery. Postoperative delirium is characterized by acute, fluctuating cognitive dysfunction within 30 days after surgery, with incidence ranging from 11% to 26%. Pathophysiology is multifactorial, and pharmacologic options are limited because of side effects and varying effectiveness. Nonpharmacologic management focuses on addressing underlying causes and early mobilization. Reducing postoperative delirium risk necessitates interprofessional, systemwide collaboration.

Conspiracy of Silence in Head and Neck Cancer Diagnosis: A Scoping Review.

Cancer disclosure represents a complex healthcare dynamic. Physicians or caregivers may be prompted to withhold diagnosis information from patients. This study aims to comprehensively map and synthesize available evidence about diagnosis nondisclosure regarding head and neck cancer (HNC) patients. Following the Joanna Briggs Institute guidelines, a scoping review was conducted across major databases without period restriction, yielding 9238 publications. After screening and selection, a descriptive synthesis was conducted. Sixteen studies were included, primarily conducted in academic settings (75%) from Europe and Asia, with a total population of 662 patients predominantly diagnosed with brain, oral, pharyngeal, or laryngeal tumors. Remarkably, 22.51% of patients were unaware of their diagnosis. Although physicians were the main source of diagnostic information (35%), they reported to often use vague terms to convey malignancy. Additionally, 13.29% of patients were aware of their diagnosis from sources other than doctors or caregivers. Caregivers (55%) supported diagnosis concealment, and physicians tended to respect family wishes. A high diagnosis-to-death interval, education, and age significantly influenced diagnosis disclosure. HNC patients expressed a desire for personalized open communication. Multiple factors influenced the decision on diagnosis disclosure. Current evidence on this topic varies significantly, and there is limited research on the consequences of nondisclosure. These findings reflect the underestimation of the patients' outlook in the diagnosis process and highlight the need for further research, aiming to establish open communication and patient autonomy during the oncological journey.

Exosomics integrates digital imaging for head and neck cancer diagnosis

AbstractCancers that can manifest in the oral cavity, nasal cavity, larynx, pharynx, sinuses, and other head and neck areas are collectively called “head and neck cancers” (HNC). HNC can be broadly classified into five types: salivary gland; oral and oropharyngeal; nasal cavity and paranasal sinus; nasopharyngeal, and laryngeal and hypopharyngeal cancers. HNC accounts for one million new diagnoses annually, making it the seventh most common form of the disease globally. Among all HNCs, 90% are head and neck squamous cell carcinoma (HNSCC) which is highly heterogenous, relapsing, and metastatic with poor survival. Despite the availability of new treatments, the five‐year survival rate for HNSCC patients has been reported to be approximately 50%. An early diagnosis may increase the disease management and outcomes, but it is challenging to detect smaller‐sized lesions and differentiate malignant and non‐malignant lesions with the available tools. Current circumstances demand an improvement in existing diagnostic strategies and the advent of novel diagnostic tools.

Changes in vaccination uptake against pneumococcal disease, influenza, and coronavirus disease 2019 (COVID-19) before and after a Head and Neck cancer diagnosis

BackgroundPneumonia is one of the main contributors to non-cancer mortality among patients with head and neck cancer (HNC). This study aimed to determine the vaccine uptake for pneumococcal polysaccharide and conjugate vaccines, quadrivalent influenza vaccines, and mRNA COVID-19 vaccines before and after an HNC diagnosis. Furthermore, the study investigated the timing of vaccination after a cancer diagnosis. Materials & methodsThis register based multicentre study included Danish patients ≥ 18y diagnosed with HNC between 2018 and 2021. The vaccine uptake was assessed by calculating cumulative incidence (CI), while the timing of vaccination after an HNC diagnosis was explored by calculating incidence rates of vaccination the first and second half year after a cancer diagnosis. ResultsThe cumulative incidence of vaccine uptake for pneumococcal vaccines was estimated to be 8 % and 16 % one year before and after an HNC diagnosis, respectively. The CIs were 36 % and 38 % for quadrivalent influenza vaccines, respectively, whereas the CIs of vaccine uptake for mRNA COVID-19 vaccines were 60 % and 89 %. The IR of mRNA COVID-19 vaccinations the first half year after HNC diagnosis were 273 per 1000 person-months of follow-up (PMFU) and 111 per 1000 PMFU the second half year, respectively (IRR: 0.38, p < 0.001). Comparing the same periods, the IR of quadrivalent influenza vaccination was 28 per 1000 PMFU and 51 per 1000 PMFU (IRR: 1.95, 0 < 0.001). The IRs of pneumococcal vaccinations were 11 per 1000 PMFU and 14 per 1000 PMFU (IRR 1.28, p = 0.21). ConclusionsAlthough our study shows a significant increase in pneumococcal and COVID-19 vaccine uptake after HNC diagnosis, a gap remains in vaccine uptake before diagnosis, underscoring the need for increased awareness of vaccination options and recommendations. Our findings could serve as a reference for future recommendations.

Causes and impact of delays during the COVID-19 pandemic on head and neck cancer diagnosis.

The causes for delays during the COVID19 pandemic and their impact on head and neck cancer (HNC) diagnosis and staging are not well described. Two cohorts were defined a priori for review and analysis-a Pre-Pandemic cohort (June 1 to December 31, 2019) and a Pandemic cohort (June 1 to December 31, 2020). Delays were categorized as COVID-19 related or not, and as clinician, patient, or policy related. A total of 638 HNC patients were identified including 327 in the Pre-Pandemic Cohort and 311 in the Pandemic Cohort. Patients in the Pandemic cohort had more N2-N3 category (41% vs. 33%, p = 0.03), T3-T4 category (63% vs. 50%, p = 0.002), and stage III-IV (71% vs. 58%, p < 0.001) disease. Several intervals in the diagnosis to treatment pathway were significantly longer in the pandemic cohort as compared to the Pre-Pandemic cohort. Among the pandemic cohort, 146 (47%) experienced a delay, with 112 related to the COVID-19 pandemic; 80 (71%) were clinician related, 15 (13%) were patient related, and 17 (15%) were policy related. Patients in the Pandemic cohort had higher stage disease at diagnosis and longer intervals along the diagnostic pathway, with COVID-19 related clinician factors being the most common cause of delay.

Treatment Complications Associated With Hospital Admission in Oropharyngeal Cancer Patients.

Oropharyngeal cancer (OPC) survivorship is a nursing priority because patients are living longer while significant short-term and long-term treatment complications that require nursing care are increasing. Hospital readmission is costly and reflects the quality of care patients receive. This secondary analysis aimed to determine the prevalence of treatment complications resulting in hospital admissions among persons with OPC and examine the relationship between treatment complications resulting in hospital admission among persons with OPC and all other persons with head and neck cancer. Using the National Inpatient Survey 2008-2019 database, we identified persons with relevant head and neck cancer diagnoses using specific International Classification of Disease ICD-9 and ICD-10 codes. Complications were operationalized by diagnosis-related codes; persons with codes for major elective surgery were excluded as our focus was posttreatment symptoms requiring hospitalization. Descriptive statistics were used to characterize persons with OPC hospitalized between 2008 and 2019. Binary logistic regression was used to assess complications using crude comparisons. The Elixhauser Comorbidity Index was used for controlling for comorbidities. The final analysis samples included 751,533: 164,770 persons with OPC and 586,763 with other head and cancers. The most prevalent diagnoses observed in those with OPC were esophagitis, nutrition disorder, hematological disorder, and renal failure; the least common diagnoses were sepsis, respiratory tract infection, and pneumonia. Binary regression revealed that persons with OPC experienced significantly more esophagitis, nutrition disorders, hematological disorders, and renal failure compared to persons with other head and neck cancers. Treatment of survivors of OPC requires more intensive monitoring for early symptoms associated with treatment, including esophagitis, nutrition disorders, bleeding disorders, and renal failure, than persons with other head and neck cancers. Monitoring laboratory values and clinical manifestations of these conditions is imperative. Nurses may encounter persons with OPC in emergency departments, outpatient radiology, or inpatient general medicine floors to manage swallowing difficulties, dehydration, malnutrition, and bleeding. Delayed or ineffective treatment of these conditions contributes to readmission, financial burden, and impairment of patient's quality of life. Future research should investigate the relationship between targeted treatment for expected complications and readmission rates in persons with OPC.

221 Sexual quality of life two years after Head and neck cancer diagnosis.

221 Sexual quality of life two years after Head and neck cancer diagnosis.

The temporal association between new head &amp; neck cancer diagnoses and local COVID-19 lockdown measures in Victoria: a population-based study

The temporal association between new head &amp; neck cancer diagnoses and local COVID-19 lockdown measures in Victoria: a population-based study

Is there an association between head and neck cancer diagnosis and self-reported dental fear? A dual-center cross-sectional study.

Mental distress is highly reported in cancer patients, resulting in anxiety and depression most of the time. Both conditions, in turn, are recognized to be related to dental fear in adults; however, there are no studies on patients suffering from head and neck cancer. Thus, the present study aimed to investigate whether newly diagnosed patients with head and neck cancer are more prone to self-reported dental fear. This dual-center cross-sectional study was conducted with 25 healthy outpatients and 25 patients with a recent diagnosis of head and neck cancer, all requiring dental care. The patients were informed at the first appointment about their dental therapy planning and the Brazilian Portuguese Version of the Dental Fear Survey (DFS) questionnaire was then applied after appropriate instructions. The DFS total scores did not differ statistically between the groups (Mann-Whitney U test, P = 0,120) but the Cancer Group presented a slightly higher mean score (32.2 ± 10.0) than the Control Group (30.0 ± 14.2). Within the limitations of this study, newly diagnosed patients with head and neck cancer and healthy individuals seem to experience similar self-reported dental fear.

The impact of COVID-19 pandemic on head and neck cancer diagnosis and treatment

Background/purposeFollowing the COVID-19 pandemic, there were reports of diagnostic delays and a surge in the prevalence of advanced head and neck cancer (HNC). We conducted a retrospective study on the impact of COVID-19 on the number of newly diagnosed HNC among patients who underwent screening at our center to understand the temporal changes. Materials and methodsWe investigated the Union for International Cancer Control guidelines-TNM classification, presence of subjective symptoms at the time of consultation, and initial treatment from the medical records of first-time patients with HNC who visited our head and neck surgery department during 2019–2021 and compared them with those before (2019) and after (2020–2021) the pandemic. ResultsA total of 1245 patients were included in the study. The number of patients were 437, 417, and 391 in 2019, 2020, and 2021, respectively, indicating a downward trend following the pandemic. When the incidence of early (stage 0–II) and advanced (stage III–IV) HNC cancers was compared, the proportion of patients with early-stage cancer declined. Among them, significant primary tumor progression was observed in T classification. The number of patients with no subjective symptoms at initial diagnosis was decreasing significantly. ConclusionA decrease in the proportion of HNC patients with early-stage cancer and primary tumor progression was observed after the pandemic in 2020 and 2021. The number of early-stage malignancies may have dropped due to patients’ unwillingness to visit a doctor.

Palliative care interventions for patients with head and neck cancer: protocol for a scoping review

IntroductionA head and neck cancer (HNC) diagnosis significantly impacts a patient’s quality of life (QOL). Palliative care potentially improves their QOL. We will conduct a scoping review to identify existing...

Factors Influencing Delay in Diagnosis of Head and Neck Cancer in Rwanda.

Head and neck cancer is a significant contributor to global otolaryngologic disease burden, with a disproportionate impact on low- and middle-income countries. This study investigates the factors contributing to delays in head and neck cancer diagnosis at the University Teaching Hospital of Kigali (CHUK). Cross-sectional study of all patients with a pathologic diagnosis of head and neck cancer presenting to CHUK between January 2021 and June 2022. Sociodemographic data, tumor characteristics, and reasons for delay were collected. Univariate and multivariable analyses were undertaken to evaluate risk factors for delays. Eighty-one patients met criteria for inclusion. Median duration from patient first reported symptoms to initial medical consultation was 52 weeks, from initial medical consultation to referral to CHUK was 4 weeks, and from referral to final pathologic diagnosis was 6 weeks. The most common reason for delay to referral to CHUK was financial (37.04%). Patients who visited traditional healers had higher odds of delay between symptom onset and medical consultation (OR 3.51, CI 1.05-11.70). Delays in final diagnosis after referral were most commonly due to OR availability for biopsy (37.04%) and time for pathology results after biopsy (35.80%). OR availability had a significant impact on duration to final diagnosis (OR 59.48, CI 7.17-493.67). Stage 4 disease had the shortest time to final diagnosis (OR 0.05, CI 0.01-0.45). Understanding the reasons for delayed diagnosis of head and neck cancer may help guide improvements in care, with the goal of reducing global head and neck burden of disease. 3; prospective non-random follow-up study Laryngoscope, 134:1663-1669, 2024.

Abstract PO-046: Relationship of HPV16 E6 seropositivity with circulating tumor tissue modified HPV DNA before head and neck cancer diagnosis

Abstract PO-046: Relationship of HPV16 E6 seropositivity with circulating tumor tissue modified HPV DNA before head and neck cancer diagnosis

Treatment priorities and regret in older adults with head and neck cancer: A systematic review.

The majority of head and neck cancer (HNC) diagnoses are seen in people aged 70 and older; these numbers are set to increase. Greater understanding of treatment needs of older patients with HNC is essential. These older patients often have co-existing health conditions, are prone to frailty and may not prioritise survival when considering treatment options. This systematic review examines the current research with regard to priorities and factors influencing treatment regret in older people with HNC. Studies were eligible for inclusion if they (i) reported data from patients with a mean age of 65 years or older who had a confirmed diagnosis of HNC and had been treated using surgery, chemotherapy and/or radiotherapy with either palliative or curative intent, (ii) considered patient's priorities or preferences or examined treatment regret as one of the primary outcomes of the study (iii) were published in English. Pilot search identified n = 7222 articles; however, following screening, only four papers met the inclusion criteria. Narrative synthesis was indicated to analyse quantitative and qualitative evidence in parallel, as meta-analyses were not possible. There is a paucity in the literature examining older adults with HNC. There is an indication that older adults prioritise maintaining independence when making treatment decisions and treatment regret is seen in those with high levels of depression with level of frailty also a contributing factor. Clinicians should consider patient's social circumstances, premorbid status and priorities in maintaining independence and managing symptoms when making treatment decisions in this cohort.

664 Rapid-Access Head and Neck Lump Imaging Clinics Improve Compliance to the NHS Faster Diagnosis Standard, With Reduction of Head and Neck Cancer Diagnosis Times

Abstract Aim The NHS “Faster Diagnosis Standard” (FDS) recommends patients referred for suspected cancer to be diagnosed or have cancer ruled out within 28 days. Reducing time to diagnosis and treatment in head and neck cancer is associated with improved patient outcomes. Our aim was to improve compliance to the 28-day standard in a large tertiary head and neck department, by introducing a rapid-access clinic for head and neck lumps including same day ultrasound-scanning with biopsy. Method Data was collected in two rounds: 3 months before and after introduction of the rapid-access clinic in September-2022. Data collected included referral reason, time from referral to specialist review, to ultrasound, and to diagnosis. Patients not fitting agreed criteria for the clinic were excluded. Results In the first round 39 patients had a diagnosis at time of analysis; as had 13 in the second round: Initial compliance to the 28-day FDS was 33%, this increased to 85% in the second round. Median time to diagnosis was 36 days, decreasing to 12 in the second round (p-value &amp;lt;0.001). Median time to ultrasound was 28.5 days in the first round, decreasing to 9 in the second round (p-value &amp;lt;0.001). Conclusions Preliminary data shows a 53% improvement in compliance to the 28-day FDS, after introduction of the rapid-access clinic. This suggests the model could significantly improve compliance to national standards for diagnosing head and neck cancer presenting via neck lumps. This should encourage other tertiary head and neck services that creating rapid-access clinics can reduce delays in cancer diagnosis and treatment.

Antibiotic Prescribing Prior to Head and Neck Cancer Diagnosis—Warning, Detour Ahead

Antibiotic Prescribing Prior to Head and Neck Cancer Diagnosis—Warning, Detour Ahead

Prevalence and correlates of high-dose opioid use among survivors of head and neck cancer.

We characterized prescription opioid medication use up to 2 years following the head and neck cancer (HNC) diagnosis and examined associations with moderate or high daily opioid prescription dose. Using administrative data from Veterans Health Administration, we conducted a retrospective cohort analysis of 5522 Veterans treated for cancers of the upper aerodigestive tract between 2012 and 2019. Data included cancer diagnosis and treatments, pain severity, prescription opioid characteristics, demographics, and other clinical factors. Two years post-HNC, 7.8% (n = 428) were receiving moderate or high-dose opioid therapy. Patients with at least moderate pain (18%, n = 996) had 2.48 times higher odds (95% CI = 1.94-3.09, p < 0.001) to be prescribed a moderate opioid dose or higher at 2 years post diagnosis. Survivors of HNC with at least moderate pain were at elevated risk of continued use of moderate and high dose opioids.

Effects of the COVID-19 Pandemic on H&N SCCa Incidence: A Population-based Analysis.

The LaryngoscopeEarly View Rapid Communication Effects of the COVID-19 Pandemic on H&N SCCa Incidence: A Population-based Analysis Neel R. Sangal MD, Corresponding Author Neel R. Sangal MD [email protected] orcid.org/0000-0002-8221-8438 Department of Otolaryngology – Head and Neck Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA Send correspondence to Neel R. Sangal, MD, Department of Otolaryngology – Head and Neck Surgery, University of Pennsylvania Health System, 3400 Spruce Street, Philadelphia, PA 19107, USA. Email: [email protected]Search for more papers by this authorPraneet Kaki BS, Praneet Kaki BS Department of Otolaryngology – Head and Neck Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USASearch for more papers by this authorJason Brant MD, Jason Brant MD orcid.org/0000-0002-3492-0679 Department of Otolaryngology – Head and Neck Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USASearch for more papers by this authorRobert M. Brody MD, Robert M. Brody MD orcid.org/0000-0001-6639-8830 Department of Otolaryngology – Head and Neck Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USASearch for more papers by this author Neel R. Sangal MD, Corresponding Author Neel R. Sangal MD [email protected] orcid.org/0000-0002-8221-8438 Department of Otolaryngology – Head and Neck Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA Send correspondence to Neel R. Sangal, MD, Department of Otolaryngology – Head and Neck Surgery, University of Pennsylvania Health System, 3400 Spruce Street, Philadelphia, PA 19107, USA. Email: [email protected]Search for more papers by this authorPraneet Kaki BS, Praneet Kaki BS Department of Otolaryngology – Head and Neck Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USASearch for more papers by this authorJason Brant MD, Jason Brant MD orcid.org/0000-0002-3492-0679 Department of Otolaryngology – Head and Neck Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USASearch for more papers by this authorRobert M. Brody MD, Robert M. Brody MD orcid.org/0000-0001-6639-8830 Department of Otolaryngology – Head and Neck Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USASearch for more papers by this author First published: 05 June 2023 https://doi.org/10.1002/lary.30804 Editor's Note: This Manuscript was accepted for publication on May 21, 2023 The authors have no other funding, financial relationships, or conflicts of interest to disclose. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article. BIBLIOGRAPHY 1Pujolar G, Oliver-Angles A, Vargas I, Vazquez ML. Changes in access to health services during the COVID-19 pandemic: a scoping review. Int J Environ Res Public Health. 2022; 19(3): 1749. 2Rygalski CJ, Zhao S, Eskander A, et al. Time to surgery and survival in head and neck cancer. Ann Surg Oncol. 2021; 28(2): 877- 885. 3Flynn W, Maqsood R, Maseland T, Montgomery J, Douglas C. Advancing head and neck cancer following the coronavirus disease 2019 pandemic. J Laryngol Otol. 2022; 136(11): 1118- 1124. 4Doll KM, Rademaker A, Sosa JA. Practical guide to surgical data sets: surveillance, epidemiology, and end results (SEER) database. JAMA Surg. 2018; 153(6): 588- 589. 5Schoonbeek RC, de Jel DVC, van Dijk BAC, et al. Fewer head and neck cancer diagnoses and faster treatment initiation during COVID-19 in 2020: a nationwide population-based analysis. Radiother Oncol. 2022; 167: 42- 48. 6Okuyama A, Watabe M, Makoshi R, Takahashi H, Tsukada Y, Higashi T. Impact of the COVID-19 pandemic on the diagnosis of cancer in Japan: analysis of hospital-based cancer registries. Jpn J Clin Oncol. 2022; 52(10): 1215- 1224. Early ViewOnline Version of Record before inclusion in an issue ReferencesRelatedInformation

The "Medicare effect" on head and neck cancer diagnosis and survival.

Uninsured individuals age 55-64 experience disproportionately poor outcomes compared to their insured counterparts. Adequate coverage may prevent these delays. This study investigates a "Medicare-effect" on head and neck squamous cell carcinoma (HNSCC) diagnosis and treatment. The Surveillance, Epidemiology, and End Results (SEER) database was queried for persons ages 60-70 years in the United States from 2000 to 2016 with HNSCC. A "Medicare effect" was defined as an increase in incidence, reduction in advanced stage presentation, and/or decrease in cancer-specific mortality (CSM). Compared to their Medicaid or uninsured counterparts, patients age 65 have an increased incidence of HNSCC diagnosis, reduction in advanced stage presentation, decrease in cancer-specific mortality, and higher likelihood of receiving cancer-specific surgery. Patients age 65 with Medicare have decreased incidence of HNSCC, less hazard of late-stage diagnosis, and lower cancer-specific mortality than their Medicaid or uninsured counterparts, supporting the idea of a "Medicare effect" in HNSCC.