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

项目总结/摘要 越来越多的头颈癌患者在更早的年龄被诊断出来， 与历史同期相比，发病率升高。这是导致人口不断扩大的头部和颈部 癌症幸存者，其中许多人将遭受治疗的重大长期影响。这些晚 健康影响，口腔健康问题始终是对患者生活质量最有害的问题之一。 然而，关于这些影响的真实发生率的有限数据缺失，特别是对于长期 癌症幸存者虽然先前的研究已经评估了小规模的机构系列的患病率，但人口- 能够更好地估计这些问题的真实负担的水平研究是有限的， 仅包括排除65岁以下患者的SEER-Medicare研究。鉴于越来越多的 由于头颈部癌症患者的诊断年龄较早，这些晚期影响的普遍程度仍然未知 在这个人群中，什么样的患者风险最大，这种风险如何随着时间的推移而演变，以及 这些迟发效应影响患者的生活质量。 犹他州拥有独特的流行病学资源--犹他州人口数据库， 医疗记录占据了该州90%的人口这个数据库与国家癌症中心 登记处、所有付款人索赔数据库、家谱记录和犹他州卫生部记录。从这个 数据库，我们已经收集了一个全面的和良好的特点为基础的人口队列超过1900 头颈部恶性肿瘤患者的长期随访。 我们提出了一个口腔健康的评价在我们的人口为基础的队列头颈部癌症的晚期效应 幸存者据我们所知，这是美国第一个此类群体。我们将评估 在临床相关的诊断后时间点上进行口腔健康诊断的患病率和风险 通过来自链接数据库的数据、医疗记录摘要和患者提供的 信息.口腔健康问题对生活质量的影响将通过经验证的一般， 疾病特异性和口腔健康特异性生活质量工具。最后，这些数据将用于开发 风险预测模型的后期健康问题，特别是临床相关性，从而翻译的研究 临床上有用的工具。这项研究将提供资料，这将是非常有益的， 通过直接告知患者咨询，扩大头颈癌幸存者的人口， 治疗决策，并确定将受益于个性化健康的高危幸存者亚组 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.