Socioeconomic Deprivation Correlates With Incomplete Radiotherapy Treatment in Head and Neck Cancer.

Area of Science:

• Oncology
• Public Health
• Health Services Research

Background:

• Merseyside faces high socioeconomic deprivation, correlating with poorer cancer outcomes, particularly for head and neck squamous cell carcinoma (HNSCC).
• Patients with HNSCC often encounter complex treatment pathways influenced by factors like health literacy, social support, and transportation, impacting adherence.

Purpose of the Study:

• To investigate the impact of socioeconomic deprivation on HNSCC patients undergoing chemoradiotherapy (CRT) or radiotherapy (RT).
• To identify specific barriers to treatment adherence among HNSCC patients in a deprived region.

Main Methods:

• Retrospective review of 359 HNSCC patients treated between June 2022 and June 2023.
• Analysis of variables including indices of multiple deprivation (IMD), unplanned admissions, hospital transport use, social support, and ad hoc appointments, correlated with missed radiotherapy appointments.

Main Results:

• 71% of CRT and 55% of RT patients had unplanned health professional appointments.
• 11% of patients missed radiotherapy appointments, most commonly due to unplanned hospital admission.
• Unplanned admission, hospital transport, and crime deprivation quintiles significantly increased the likelihood of missed appointments.

Conclusions:

• High rates of unplanned healthcare encounters support adherence to non-surgical HNSCC treatments.
• Formalizing ad hoc appointments can create a more equitable service.
• Hospital transport use is associated with missed appointments; improved transport services and patient experience insights are vital for adherence.