The authors have no funding, financial relationships, or conflicts of interest to disclose.
Quality of Life
Factors associated with nonparticipation in one-year quality-of-life assessment in patients with head and neck squamous cell carcinoma†
Version of Record online: 26 APR 2010
Copyright © 2010 The American Laryngological, Rhinological, and Otological Society, Inc.
Volume 120, Issue 7, pages 1435–1443, July 2010
How to Cite
Gourin, C. G., Kaboli, K. C., Boyce, B. J. and Burkhead, L. M. (2010), Factors associated with nonparticipation in one-year quality-of-life assessment in patients with head and neck squamous cell carcinoma. The Laryngoscope, 120: 1435–1443. doi: 10.1002/lary.20952
- Issue online: 25 JUN 2010
- Version of Record online: 26 APR 2010
- Manuscript Accepted: 2 MAR 2010
- Quality of life;
- head and neck neoplasms;
- squamous cell cancer;
- nonoperative treatment;
- Level of Evidence: 2.
To identify factors associated with nonparticipation in long-term quality-of-life (QOL) analysis in head and neck squamous cell cancer (HNSCC) patients.
Restrospective analysis of prospectively collected data.
Two hundred sixty-one previously untreated HNSCC patients were prospectively evaluated using the University of Washington QOL questionnaire. Questionnaires were administered before treatment and at 1 year following treatment. Patients without data at 1 year were classified as nonparticipants.
At 1 year, 152 patients (58%) had complete QOL data. Nonparticipants differed from participants by stage, comorbidity, and disease status, with a greater proportion of patients with advanced stage disease, advanced comorbidity, and recurrent disease participating in QOL analysis at 1 year (P < .05). No significant differences were found between nonparticipants and participants with respect to age, race, primary site, treatment, travel distance, or socioeconomic variables. Multiple linear regression analysis showed differences in initial QOL scores between participants and nonparticipants only for activity, with lower mean initial scores for nonparticipants (β = −9.9, 95% confidence interval, −16.8 to −3.0; P = .005). Multiple logistic regression demonstrated significant differences in the odds of nonparticipation at 1 year for males (odds ratio [OR] 0.4, P = .01), T4 disease (OR 0.3, P = .001), uninsured patients (OR 2.8, P = .007), recurrent disease (OR 0.2, P < .0001), and comorbidity (OR 0.5, P = .025), after controlling for all other variables.
Long-term QOL analysis may be biased by greater participation from patients who require greater medical attention because of advanced tumor stage, recurrent disease, or comorbidity, whereas patients without insurance are under-represented. These findings suggest limitations to the interpretation and application of long-term QOL data. Laryngoscope, 2010