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Related Experiment Video

Updated: Jun 24, 2025

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Factors Associated with Head and Neck Cancer Postoperative Radiotherapy Delays: A Systematic Review and

Kelsey A Duckett1, Mohamed Faisal Kassir1, Shaun A Nguyen1

  • 1Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|June 6, 2024
PubMed
Summary

Delays in postoperative radiotherapy for head and neck cancer disproportionately affect minority and low-income patients, as well as those with longer hospital stays or readmissions. Addressing these factors is crucial for equitable cancer care.

Keywords:
Commission on CancerNational Comprehensive Cancer Networkadjuvant therapyhead and neck cancerhealth equityqualityradiotherapysocial determinants of health

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Area of Science:

  • Oncology
  • Health Services Research
  • Health Equity

Background:

  • Postoperative radiotherapy (PORT) within 6 weeks is a quality metric for head and neck squamous cell carcinoma (HNSCC).
  • Factors contributing to delays in PORT initiation are not well-understood.

Purpose of the Study:

  • To systematically describe and synthesize factors associated with delays in initiating PORT for HNSCC patients.
  • To identify patient and clinical characteristics linked to delayed PORT.

Main Methods:

  • Systematic review of PubMed, Scopus, and CINAHL databases.
  • Meta-analysis of odds ratios (ORs) from 15 studies including patients treated in the US after 2003.
  • Inclusion criteria focused on demographic, clinical, and social determinants of health associated with PORT delay (>6 weeks).

Main Results:

  • Black race (OR, 1.46), Hispanic ethnicity (OR, 1.37), Medicaid/no insurance (OR, 2.01), and lower income (OR, 1.38) were associated with PORT delay.
  • Postoperative admission >7 days (OR, 2.92) and 30-day hospital readmission (OR, 1.37) significantly increased the risk of delay.
  • 21 studies were included in the review, with 15 contributing to the meta-analysis.

Conclusions:

  • Patients from minoritized communities and lower socioeconomic status are at higher risk for delayed PORT.
  • Postoperative complications, such as prolonged hospital stays and readmissions, are significant predictors of PORT delay.
  • Findings support the development of targeted interventions to improve equity and quality in HNSCC care delivery.