M Bryant Howren1,2,3,4, Alan J Christensen1,5, Jenna L Adamowicz1,6, Aaron Seaman1,4,7, Shylo Wardyn1,4, Nitin A Pagedar8. 1. VA Office of Rural Health (ORH), Veterans Rural Health Resource Center, Iowa City VA Health Care System, Iowa City, Iowa, USA. 2. Department of Behavioral Sciences & Social Medicine, College of Medicine, Florida State University, Tallahassee, Florida, USA. 3. Florida Blue Center for Rural Health Research & Policy, College of Medicine, Florida State University, Tallahassee, Florida, USA. 4. Center for Access Delivery Research & Evaluation (CADRE), Iowa City VA Healthcare System, Iowa City, Iowa, USA. 5. Department of Psychology, East Carolina University, Greenville, North Carolina, USA. 6. Department of Psychological & Brain Sciences, the University of Iowa, Iowa City, Iowa, USA. 7. Department of Internal Medicine, the University of Iowa, Iowa City, Iowa, USA. 8. Department of Otolaryngology-Head and Neck Surgery, Carver College of Medicine, the University of Iowa, Iowa City, Iowa, USA.
Abstract
OBJECTIVE: Problem alcohol use in persons with head and neck cancer (HNC) is associated with poor outcomes, including survival. Some evidence suggests that individuals living in rural areas may be at greater risk of problem alcohol use. The present exploratory cross-sectional study sought to examine problem alcohol use at diagnosis in a sample of HNC patients by rural versus urban status. METHODS: Self-reported problem alcohol use as measured by the Short Michigan Alcoholism Screening Test (SMAST) was examined in rural and urban HNC patients at diagnosis (N = 454). Multivariable linear regression analysis was conducted to examine correlates of problem alcohol use. Subgroup analyses examined HNC-specific health-related quality of life (HRQOL) by problem drinking status at diagnosis and 3- and 12-month postdiagnosis in rural patients. RESULTS: Multivariable linear regression analysis controlling for age, cancer site, cancer stage, depressive symptoms at diagnosis, and tobacco use at diagnosis indicated that rural residence was significantly associated with SMAST scores at diagnosis such that rural patients were more likely to report higher scores (ß = 0.095, sr2 = 0.010, p = 0.04). Covariate-adjusted subgroup analyses suggest that rural patients with self-reported problem alcohol use may exhibit deficits in HNC-specific HRQOL at diagnosis and 3- and 12-month postdiagnosis. CONCLUSIONS: HNC patients should be screened for problem alcohol use at diagnosis and counseled regarding the deleterious effects of continued drinking during treatment and beyond. Because access to treatment and referral options may be lacking in rural areas, additional ways of connecting rural patients to specialty care should be explored. Published 2020. This article is a U.S. Government work and is in the public domain in the USA.
OBJECTIVE: Problem alcohol use in persons with head and neck cancer (HNC) is associated with poor outcomes, including survival. Some evidence suggests that individuals living in rural areas may be at greater risk of problem alcohol use. The present exploratory cross-sectional study sought to examine problem alcohol use at diagnosis in a sample of HNC patients by rural versus urban status. METHODS: Self-reported problem alcohol use as measured by the Short Michigan Alcoholism Screening Test (SMAST) was examined in rural and urban HNCpatients at diagnosis (N = 454). Multivariable linear regression analysis was conducted to examine correlates of problem alcohol use. Subgroup analyses examined HNC-specific health-related quality of life (HRQOL) by problem drinking status at diagnosis and 3- and 12-month postdiagnosis in rural patients. RESULTS: Multivariable linear regression analysis controlling for age, cancer site, cancer stage, depressive symptoms at diagnosis, and tobacco use at diagnosis indicated that rural residence was significantly associated with SMAST scores at diagnosis such that rural patients were more likely to report higher scores (ß = 0.095, sr2 = 0.010, p = 0.04). Covariate-adjusted subgroup analyses suggest that rural patients with self-reported problem alcohol use may exhibit deficits in HNC-specific HRQOL at diagnosis and 3- and 12-month postdiagnosis. CONCLUSIONS: HNC patients should be screened for problem alcohol use at diagnosis and counseled regarding the deleterious effects of continued drinking during treatment and beyond. Because access to treatment and referral options may be lacking in rural areas, additional ways of connecting rural patients to specialty care should be explored. Published 2020. This article is a U.S. Government work and is in the public domain in the USA.
Entities:
Keywords:
alcohol consumption; head and neck cancer; health-related quality of life; psycho-oncology; rural health