Identifying unmet supportive care needs in head and neck cancer patients through standardized patient-reported screening.

344 Background: Patients with head and neck cancer (HNC) have a high symptom burden related to both disease and treatment. Standardized screening can identify unmet supportive care (SC) needs and facilitate early integration of interdisciplinary services. Referral patterns and drivers of SC needs in this population are understudied. Methods: We retrospectively analyzed HNC patients who completed the Fred Hutch Supportive Care Questionnaire (SCQ), an electronic patient-reported outcomes screen administered prior to the initial visit. The SCQ includes validated assessments across multiple domains; positive responses initiate referrals to services including social work, nutrition, tobacco cessation, physical therapy, palliative care, and others. We analyzed rates and types of positive screens, stratified referrals by age (< 65 vs ≥65) and compared HNC referral patterns to a broader solid tumor cohort. Results: From 1/2023 to 1/2025, 163 HNC patients completed the SCQ; 110 (67.5%) screened positive in at least one domain. The most common referrals were social work (n = 61, 56%), nutrition (n = 57, 52%), tobacco cessation (n = 24, 22%), and patient navigation (n = 20, 18%). Reasons for social work referral included depression (45%), anxiety (37%), and alcohol use (44%). Among nutrition referrals, 94% reported weight loss and 15% used feeding tubes. Food insecurity was reported by 9% of HNC overall and accounted for 70% of patient navigation referrals. Rates of positive screens were similar by age group (69% < 65 vs. 65% ≥65, p = 0.7), but referral patterns differed: younger patients were more likely to be referred to child life (p < 0.001), tobacco cessation (p = 0.003), and oncofertility (p < 0.001), while older adults more frequently received physical therapy (p = 0.039) and palliative care (p = 0.049) referrals. Compared to a general solid tumor cohort (n = 5905), patients with HNC had higher referral rates for social work (37% vs. 29%), nutrition (35% vs. 23%), and tobacco cessation (15% vs. 9%), highlighting their unique SC needs. Conclusions: Over two-thirds of HNC patients screened positive for SC needs at initial referral, underscoring the importance of integrated interdisciplinary care. Psychosocial, behavioral, and nutritional needs were particularly prevalent. Standardized screening like the SCQ may enable proactive referrals, optimize SC delivery, and inform resource allocation to meet the highest priority needs for this high-risk population.