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Higher Prevalence of Hearing Loss Among Cancer Survivors

by Linda Kossoff •

CLINICAL QUESTION

What is the prevalence of subjective and objective hearing loss (HL) in cancer survivors as compared to that of the general population?

BOTTOM LINE

Findings suggest that cancer survivors have a significantly higher prevalence of both audiometry-confirmed and self-reported HL than the general population.

BACKGROUND: Cancer survivors are at greater risk of developing HL due to older age, chemotherapy, and radiotherapy. Although the number of U.S. cancer survivors has increased substantially in recent years, the prevalence of HL among them remains unknown. Moreover, uniform HL screening guidelines for this population are lacking.

STUDY DESIGN: Cross-sectional study.

SETTING: University Hospitals Seidman Cancer Center, Cleveland.

SYNOPSIS: Researchers randomly selected 9,337 adults who underwent audiometry testing and responded to a National Health and Nutrition Examination Survey hearing questionnaire during periods from 2011 to 2020 (prepandemic). They analyzed audiometry results and responses to two subjective survey questions related to troublesome hearing and tinnitus. Objective HL was defined by pure-tone averages greater than 20 dB HL. Of the 9,337 participants who completed both tests, 848 (55.6% women, mean age 62.7 years) were cancer survivors. Audiometry-confirmed results showed that cancer survivors had 43% higher odds of having speech-frequency HL and high-frequency HL than the general population. Subjective measures showed that cancer survivors had 43% increased odds of reporting troublesome hearing and of tinnitus than the general population. The discovered sensitivity of the single question method in detecting both types of HL in cancer survivors compared to the general population suggests this method’s potential in HL detection. Study limitations included the possibility that participants with severe HL and tinnitus were not selected for the survey.

CITATION: Wang Q, Jiang C, Wen C, et al. Subjective and objective hearing loss among US adult cancer survivors. JAMA Otolaryngol Head Neck Surg. Published online October 5, 2023.