The following is a summary of “Time to treatment patterns of head and neck cancer patients before and during the COVID-19 pandemic,” published in the November 2023 issue of Oncology by Tasoulas et al.
Over the last few decades, there have been big changes in how healthcare is provided. The clinicodemographic factors and treatment trends of people with head and neck squamous cell cancer (HNSCC) from 2004 to 2020 were analyzed by researchers for a study—analysis of groups of HNSCC cases from the National Cancer Data Base from 2004 to 2020. There were a total of 164,290 cases. Between 2004 and 2019, the time it took from diagnosis to definitive surgery (TTS) got longer at all types of facilities, but it got longer at non-academic centers (NAC) than at academic centers (AC). There was a higher risk of death for TTS < 15 days (RR = 1.05, 95%CI:1.05–1.09) and > 75 days (1.07, 95% CI:1.05–1.09). This link was stronger for people with HPV and HNSCC (RR = 1.45; 95% CI: 1.18–1.78). Treatment in AC was linked to a lower chance of death (RR = 0.94, 95%CI:0.93–0.95).
Even though wait times went up everywhere from 2004 to 2019, short-term mortality went down a lot from 2016 to 2019 compared to 2004 to 2007 (3-month mortality: RR = 0.77, 95%CI:0.70–0.85; 12-month mortality: RR = 0.80, 95% CI:0.77–0.84). In 2020, wait times went down. Between 2004 and 2019, TTS went up, and NAC was hit the hardest.
However, short-term survival increased significantly, even though wait times got longer. Very short (<15 days) and very long (>75 days) TTS were linked to higher death rates. The rate of growth is highest for people with HPV and HNSCC who were treated more than 75 days after being diagnosed. Treatment at AC was linked to a higher chance of life, which may be because there are more diverse teams and subspecialists there than at NAC. For a full look at wait times in 2020, the NCDB records from 2021 were needed.
Source: sciencedirect.com/science/article/abs/pii/S1368837523002312