title: Factors that impact health-related quality of life over time for individuals with head and neck cancer.
abstract: To identify sociodemographic, behavioral, and clinical factors associated with health-related quality of life (HRQOL) for head and neck cancer (HNC) patients over time.
  
  
  
  A population-based longitudinal cohort study.
  
  
  
  Newly diagnosed HNC patients (N = 587) were administered the Functional Assessment of Cancer Therapy-Head and Neck questionnaire at baseline (median 3 months postdiagnosis) and two follow-up assessments (median 22 and 42 months). Linear mixed-effect models were used with backward variable selection to identify factors associated with HRQOL over time (P < .05). Adjusted means reported at 2 years postdiagnosis.
  
  
  
  African Americans reported better Functional Well-Being than whites (mean of 20.01 vs. 18.53) and fewer HNC symptoms over time. Older patients (75+ years) reported better HRQOL than younger patients (< 50 years). Current tobacco use compared to no tobacco use had worse Physical (20.20 vs. 21.50), Emotional (17.55 vs. 19.06), Social (21.28 vs. 22.88), and Functional (17.32 vs. 19.29) Well-Being and more HNC symptoms (21.50 vs. 23.71). Radiation therapy was associated with worse Physical and Functional Well-Being and more head and neck symptoms over time, but HRQOL was similar to those who were not irradiated by 2 to 4 years postdiagnosis.
  
  
  
  This study identified key factors for individuals at risk for poorer HRQOL that may help clinicians and caregivers find solutions to address these decrements. Smoking cessation programs can be encouraged for survivors who use tobacco. Psychological and social support and medications may help for dealing with emotional distress and dealing with the physical symptoms from treatment.
  
  
  
  4. Laryngoscope, 126:2718-2725, 2016.
authors.affiliation: Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A.|Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A.|Sheps Health Services Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A.
authors.forename: Bryce B
authors.initials: BB
authors.lastname: Reeve
authors.affiliation: Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A.
authors.forename: Jianwen
authors.initials: J
authors.lastname: Cai
authors.affiliation: Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A.
authors.forename: Hongtao
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A.
authors.forename: Mark C
authors.initials: MC
authors.lastname: Weissler
authors.affiliation: Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A.
authors.forename: Kathy
authors.initials: K
authors.lastname: Wisniewski
authors.affiliation: Sheps Health Services Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A.
authors.forename: Heather
authors.initials: H
authors.lastname: Gross
authors.affiliation: Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A.|Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A.|Department of Otolaryngology-Head & Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A.
authors.forename: Andrew F
authors.initials: AF
authors.lastname: Olshan
mesh_terms: D000328:Adult; D001741:Black or African American; D000368:Aged; D005260:Female; D006258:Head and Neck Neoplasms / Q000208:ethnology; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D017741:Survivors; D044465:White People
keywords: Health-related quality of life; head and neck cancer; longitudinal study; radiation therapy; symptoms