Uncovering Care Challenges for Head and Neck Cancer Patients and Caregivers in the United States: A Scoping Review

Individuals undergoing treatment for head and neck cancer (HNC) face numerous challenges, including financial and food insecurity, which affect both the patients and their caregivers. This scoping review explores and consolidates the current literature addressing the care challenges experienced by HNC patients and their caregivers. Eligible studies were identified through a search of MEDLINE and Embase databases. The scoping review was conducted in accordance with Arksey and O'Malley's five-stage methodology and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. Data extraction and analysis were performed using a thematic approach. The inclusion criteria encompassed full-text articles published in English that examined challenges faced by both adult HNC patients and caregivers as primary outcomes in the United States. Eligible studies underwent assessment using the Covidence data screening and extraction tool. Information encompassing general study details, article characteristics, and scoping review-relevant details were extracted through Research Electronic Data Capture (REDCap). Out of the 822 articles initially identified, 40 met the inclusion criteria. The majority of these comprised descriptive surveys (n = 23; 54%), retrospective chart reviews (n = 7; 18%), cross-sectional studies (n = 6; 15%), and prospective cohort studies (n = 13). Within the included studies, the majority of the studies (n = 36) concentrated on quantifying and describing the financial toxicity and out-of-pocket costs experienced by patients with HNC. Two articles concentrated on challenges associated with providing nutritional care to patients with HNC. Additionally, four studies explored the quality of life and the burden experienced by caregivers of patients undergoing treatment for HNC. Despite the existing body of literature addressing the financial challenges faced by patients with HNC, a noticeable gap exists in the literature concerning challenges related to providing nutritional care and the obstacles faced by caregivers in delivering care to this population. This scoping review offers a comprehensive overview of these challenges and the literature's current focus on addressing them. The findings emphasize the necessity for further research to gain a deeper understanding of the experiences of both patients and caregivers, evaluate the impact of interventions, and bridge knowledge gaps. Ultimately, such endeavors will contribute to enhancing the quality of care and support for individuals affected by HNC.