Assessing Long‐Term Quality of Life Concerns Through Survivorship Clinic in Head and Neck Cancer Patients

Abstract Objective To characterize the concerns of head and neck cancer (HNC) patients and discern changes in quality‐of‐life (QoL) during long‐term follow‐up. Study Design Retrospective review. Setting Survivorship clinic at a tertiary academic center. Methods A retrospective review was conducted on HNC patients seen in our survivorship clinic between 1/2020 and 1/2024 using the University of Washington Quality of Life (UW‐QOL) Questionnaire. Results Three hundred and forty‐two patients were seen for 914 encounters. Patients were divided into 4 groups: pretreatment (n = 326), 0 to 12 months posttreatment (n = 247), 1 to 3 years posttreatment (n = 248), and more than 3 years posttreatment (n = 64). The average follow‐up after treatment was 459 days (range: 0‐5.2 years). Multivariable analysis revealed significant improvements in overall QoL, health‐related QoL, social‐emotional composite scores, activity, anxiety, appearance, chewing, mood, pain, speech, and recreation at more than 1‐year posttreatment compared to less than 1‐year posttreatment. However, declines were noted in saliva and taste scores. No differences in scores were observed between patients 1 to 3 years posttreatment and those >3 years posttreatment. At all timepoints before and after treatment, top concerns were pain, activity, and swallowing. Patients with oral cancer followed for more than 1‐year posttreatment had worse scores in appearance, chewing, pain, and speech compared to those with oropharyngeal cancer. Conclusions Understanding the evolving concerns of HNC patients is imperative for enhancing care. Most QoL domains improve at 1‐year posttreatment except for saliva, taste, swallowing, and shoulder function. QoL scores stabilize after 1‐year post‐treatment. Pain, activity, and swallowing remain the top concerns at all time points.