Subjective and Objective Hearing Loss Among US Adult Cancer Survivors

Area of Science:

• Audiology
• Oncology
• Public Health

Background:

• Cancer survivors face increased risks of hearing loss (HL) due to treatments like chemotherapy and radiotherapy, as well as older age.
• The prevalence of HL among cancer survivors in the US is not well-established, and uniform screening guidelines are lacking.

Purpose of the Study:

• To estimate the prevalence of subjective and objective HL in US cancer survivors.
• To compare HL prevalence between cancer survivors and the general population.
• To evaluate the effectiveness of subjective hearing questions in identifying objective HL.

Main Methods:

• A cross-sectional study using data from the National Health and Nutrition Examination Survey (2011-2020).
• Included adults aged 20-80 with audiometry testing and hearing questionnaire responses.
• Weighted prevalence calculations and logistic regression models were used for comparisons and performance evaluation.

Main Results:

• Cancer survivors showed a higher prevalence of troublesome hearing (1.43 AOR) and high-frequency HL (1.74 AOR) compared to the general population.
• Subjective hearing questions demonstrated strong performance in detecting objective HL, with AUCs of 0.88 for speech-frequency HL and 0.90 for high-frequency HL.
• The study included a weighted sample of over 90 million individuals, with 10.3% identified as cancer survivors.

Conclusions:

• Cancer survivors have a significantly higher prevalence of hearing loss than the general population.
• Two subjective hearing questions can serve as an effective and efficient screening tool for healthcare professionals.
• Increased awareness, education, and early screening are crucial for managing hearing loss in cancer survivors.