Cancer care coordination determinants of depression in head and neck cancer survivors

This study aims to explore the role of patient-reported cancer care coordination in explaining depression among head and neck (HNC) cancer survivors.

In this cross-sectional study, the University of California Los Angeles Health tumor registry was used to recruit English-proficient adult HNC survivors who were at least 1-year post-diagnosis. Participants completed the Cancer Care Coordination Questionnaire for Patients (CCCQ-P) and the Patient Reported Outcomes Measurement Information Systems (PROMIS) Short Form v1.0, Depression 4a, as part of a comprehensive survey. Data were analyzed using the Generalized Boosted Regression Models.

A total of 347 HNC survivors participated, with the majority being male (66.6%), white (81.5%), married (70.6%), and on average 44.4 months since cancer diagnosis. The average CCCQ-P scores were 74.6 (SD = 14.6). Factors associated with depression included confusion regarding healthcare professionals' roles, insufficient support from oncology staff, overall ratings of cancer care coordination, the absence of a caregiver, and being in mid-adulthood.

We identified correlates of depression among HNC survivors related to the patient care experience. This finding suggests that improving care coordination may increase opportunities to improve HNC survivors' mental health outcomes and long-term quality of life.

Clear clinical pathways are essential for linking patient needs to care resources. Tools that efficiently identify patient concerns, like the NCCN distress thermometer and patient concerns inventory, and connect them to algorithms for tailored support should be considered for implementation. Patient navigators may also enhance care coordination by clarifying specific roles of the multidisciplinary team, improving communication and reducing care delays.