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A cross-sectional survey assessing clinicians’ perspectives towards redesigning the surveillance model for head and neck cancer: can we do better?

  • Head and Neck
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Background

Service delivery of post-treatment surveillance in head and neck cancer (HNC) varies across institutions in Australia. To better understand current practices and develop protocols that maximize service capacity or incorporate emerging technologies, especially in under-resourced regional and remote communities, it is important to obtain the perspectives of clinicians that regularly manage patients with HNC.

Design

This cross-sectional study utilized an online survey distributed via email to specialists recruited from HNC-associated networks across Australia. The survey captured information on current practices and explored clinician perspectives towards re-designing the current surveillance model to incorporate telehealth or patient-reported outcome measures (PROMs). Quantitative data was analyzed using descriptive statistics while open-ended survey comments were analyzed using a content analysis approach.

Results

Forty participants completed the survey (25 surgeons, 9 medical oncologists, 5 radiation oncologists and 1 oral medicine specialist). Most clinicians used either institution-specific guidelines (44%) or National Comprehensive Cancer Network guidelines (39%), with the remaining 17% using surveillance intervals based on patient symptoms. Following treatment, 53% of participants imaged patients only when there was clinical suspicion of recurrence or new symptoms. Planned surveillance imaging was conducted at 6 or 12-monthly intervals based on the HNC subtype. Fifty-seven percent of clinicians were open to redesigning the surveillance model, specifically in low-risk patients who did not require nasoendoscopic examination. Seventy-one percent had concerns regarding the feasibility of telehealth appointments, citing disparities in digital health equity. Additionally, 61% felt PROMs are currently underutilized and were open to incorporating HNC-specific PROMS into surveillance. Open-ended responses indicated that within the current surveillance model, “fragmented service provision” and “administration issues” were significantly impacting on timing of care.

Conclusion

Surveyed HNC clinicians feel that current post-treatment surveillance can be fragmented and potentially lead to delayed care. They are open to incorporating PROMS to assist in surveillance scheduling, especially in low-risk patients.

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Data availability

All data supporting the findings of this study are available within the paper and its Supplementary Information.

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Acknowledgements

The authors would like to thank Dr Himani Joshi for her assistance in pilot testing the clinician survey.

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

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Authors and Affiliations

  1. Department of Otolaryngology and Head and Neck Surgery, Flinders Medical Centre, Adelaide, Australia

    Grace Maina, Charmaine Woods & Eng H. Ooi

  2. College of Nursing &, Health Sciences Flinders University, Adelaide, Australia

    Fiona Crawford-Williams

  3. College of Medicine and Public Health, Flinders University, Adelaide, Australia

    Charmaine Woods & Eng H. Ooi

  4. ENT Department, The Queen Elizabeth Hospital, Woodville, 5011, Australia

    Grace Maina

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  1. Grace Maina
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Correspondence to Grace Maina.

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Maina, G., Crawford-Williams, F., Woods, C. et al. A cross-sectional survey assessing clinicians’ perspectives towards redesigning the surveillance model for head and neck cancer: can we do better?. Eur Arch Otorhinolaryngol (2024). https://doi.org/10.1007/s00405-024-08791-x

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