Improving Our Understanding of Late Oral Health Effects in Head and Neck Cancer Survivors

项目摘要/摘要 越来越多的头颈部癌症患者在更早的年龄被诊断出来，并在 与历史上的队列相比，比率更高。这导致了头部和颈部的人口不断扩大。 癌症幸存者，他们中的许多人将遭受治疗的重大长期影响。这些已故的人 对于健康影响，口腔健康问题一直是对患者生活质量最不利的问题之一。 然而，缺乏关于这些影响的真实流行的有限数据，特别是对于长期而言 癌症幸存者。虽然先前的研究评估了小规模、制度性系列的患病率，但人口- 能够对这些问题的真实负担提供更好估计的水平研究是有限的，并且 只包括排除65岁以下患者的SEER-Medicare研究。鉴于越来越多的 确诊年龄较早的头颈癌患者，这些晚期影响有多普遍尚不清楚 在这一人群中，哪些患者面临的风险最大，这种风险是如何随时间演变的，以及 这些后遗症都会影响患者的生活质量。 犹他州有一个独特的流行病学资源，犹他州人口数据库，它提供了 这些医疗记录涵盖了该州90%的人口。这个数据库与该州的癌症有关 登记处、所有付款人索赔数据库、家谱记录和犹他州健康记录部。由此 数据库，我们已经汇集了一个全面的、特征明确的、以人口为基础的队列，超过1900人 对头颈癌患者进行长期随访。 我们建议对我们以人群为基础的头颈癌队列的口腔健康晚期效应进行评估。 幸存者。据我们所知，这是美国第一个这样的群体。我们将评估 超过临床相关诊断后时间点的口腔健康诊断的患病率和风险 通过来自链接数据库、医疗记录摘要和患者提供的数据的组合 信息。口腔健康问题对生活质量的影响将通过验证的一般情况进行评估， 针对特定疾病和口腔健康的生活质量测量工具。最后，这些数据将被用于开发 具有特殊临床相关性的晚期健康问题的风险预测模型，从而将该研究转化为 将发现转化为临床有用的工具。这项研究将提供的信息将对 通过直接告知患者咨询，扩大头颈部癌症幸存者的人口，影响 治疗决策，并确定将受益于个性化健康的高危幸存者亚群 干预措施。

PROJECT SUMMARY / ABSTRACT Head and neck cancer patients are increasingly being diagnosed at earlier ages and surviving their cancers at elevated rates compared to historic cohorts. This is leading to an expanding population of head and neck cancer survivors, many of whom will suffer from the significant long-term effects of treatment. Of these late health effects, oral health problems consistently rate among the most detrimental to patient quality of life. However, limited data regarding the true prevalence of these effects is missing, particularly for long-term cancer survivors. While prior research has evaluated the prevalence in small, institutional series, population- level studies that are able to provide a better estimate of the true burden of these problems are limited and consist only of SEER-Medicare studies that exclude patients under the age of 65. Given the increasingly earlier age of diagnosis of head and neck cancer patients, it remains unknown how pervasive these late effects are in this population, what patients are most at risk, how that risk evolves over time, and what the impact of these late effects are to patient quality of life. The State of Utah has a unique epidemiologic resource, the Utah Population Database, that provides access to the medical records capturing ~90% of the state's population. This database is linked with the State's cancer registry, All Payers Claims Database, genealogy records, and Utah's Department of Health Records. From this database we have assembled a comprehensive and well-characterized population-based cohort of over 1,900 head and neck cancer patients with long-term follow-up. We propose an evaluation of oral health late effects in our population-based cohort of head and neck cancer survivors. To our knowledge, this cohort is the first of its kind in the United States. We will assess the prevalence and risk of developing oral health diagnoses over clinically relevant post-diagnosis time points through a combination of data from the linked databases, medical records abstraction, and patient provided information. The impact of oral health problems on quality of life will be assessed with validated general, disease-specific, and oral health specific quality of life instruments. Finally, these data will be used to develop risk prediction models for late health problems of particular clinical relevance, thereby translating the study findings into clinically useful tools. This study will provide information that will be of great benefit to the expanding population of head and neck cancer survivors by directly informing patient counseling, impacting treatment decisions, and identifying at-risk survivor subgroups that will benefit from personalized health interventions.