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Travel Distance Alone Not Associated with Worsened Two-Year Survival in Patients with Newly Diagnosed Head and Neck Cancer

by Linda Kossoff •

What is the relationship between distance traveled and rurality to clinical timepoints and two-year, disease-free survival (DFS) in newly diagnosed head and neck cancer (HNC) patients?

BOTTOM LINE

An association between rurality and delay in HNC workup did not lead to worsened two-year DFS, and an association between distance traveled and some clinical timepoints had no impact on DFS.

BACKGROUND: Although HNC prevalence has decreased, incidence of late-stage HNC is increasing. Rurality is associated with higher cancer rates related to risk factors that are highly associated with development of HNC, such as HPV and smoking; however, the impact of travel distance on survival of patients with HNC is not established.

STUDY DESIGN: Retrospective analysis.

SETTING: Department of Otolaryngology–Head and Neck Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.

SYNOPSIS: Researchers conducted a search for patients who were seen at a single institution for a diagnosis of HNC from 2015 to 2019. A total of 509 patients (72.9% male, mean age 64 years) were included in their analysis. Key independent variables included distance to an academic medical center and rurality score. The sample was divided into two groups based on an optimal treatment timeline to assess for the impact of distance traveled. A higher proportion of patients in the optimal treatment timeline group resided in metropolitan areas. These patients also had a shorter duration from first presentation for HNC to presentation to a medical center and a shorter duration from referral to presentation. However, there was no significant difference in two-year DFS between the two groups. Patients who lived in suburban communities around the center were most likely to initiate treatment within one month of presentation. Overall, results showed no impact on two-year DFS, suggesting that socioeconomic and patient factors, instead of travel distance alone, impact HNC workup patterns. Study limitations included lack of a long follow-up period.

CITATION: Debick N, Gemmiti A, Ryan J. The impact of distance traveled and rurality on the clinical course of head and neck cancer [published online ahead of print April 17, 2023] Laryngoscope Investig Otolaryngol.