Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Feb;41(2):479-487.
doi: 10.1002/hed.25412. Epub 2018 Dec 7.

Two-year prevalence of dysphagia and related outcomes in head and neck cancer survivors: An updated SEER-Medicare analysis

Katherine A Hutcheson  1 , Zhannat Nurgalieva  1 , Hui Zhao  2 , Gary B Gunn  3 , Sharon H Giordano  2 , Mihir K Bhayani  4 , Jan S Lewin  1 , Carol M Lewis  1
Affiliations

Two-year prevalence of dysphagia and related outcomes in head and neck cancer survivors: An updated SEER-Medicare analysis

Katherine A Hutcheson et al. Head Neck. 2019 Feb.

Abstract

Background: The aim of the study was to examine prevalence of dysphagia at the population level in head and neck cancer (HNC) survivors.

Methods: Surveillance, Epidemiology, and End Results-Medicare claims among 16 194 patients with HNC (2002-2011) were analyzed to estimate 2-year prevalence of dysphagia, stricture, and aspiration pneumonia, and derive treatment- and site-specific estimates.

Results: Prevalence of dysphagia, stricture, pneumonia, and aspiration pneumonia was 45.3% (95% confidence interval [CI]: 44.5-46.1), 10.2% (95% CI: 9.7-10.7), 26.3% (95% CI: 25.6-26.9), and 8.6% (95% CI: 8.2-9.1), respectively. Dysphagia increased by 11.7% over the 10-year period (P < .001). Prevalence was highest after chemoradiation and multimodality therapy.

Conclusion: Comparing to published rates using similar methodology the preceding decade (1992-1999), prevalence of dysphagia based on claims data was similar in 2002-2011 in this study. These results suggest persistence of dysphagia as a highly prevalent morbidity, even in the decade in which highly conformal radiotherapy and minimally invasive surgeries were popularized.

Keywords: SEER-Medicare; aspiration pneumonia; dysphagia; head and neck cancer; stricture.

PubMed Disclaimer

Conflict of interest statement

CONFLICT OF INTEREST: The authors made no disclosures.

Figures

FIGURE 1.
FIGURE 1.
Two year prevalence of swallowing-related events by treatment modality (top) and disease sub-site (bottom), n=16,194.
FIGURE 2.
FIGURE 2.
Adjusted odds of 2-year swallowing-related events by treatment modality, n=16,194. Adjusted for age, sex, race/ethnicity, tumor site, comorbidity stage, SEER stage. CRT: chemoradiation
FIGURE 2.
FIGURE 2.
Adjusted odds of 2-year swallowing-related events by treatment modality, n=16,194. Adjusted for age, sex, race/ethnicity, tumor site, comorbidity stage, SEER stage. CRT: chemoradiation
FIGURE 3.
FIGURE 3.
Adjusted odds of dysphagia, stricture, pneumonia and aspiration pneumonia by treatment modality.
See this image and copyright information in PMC

References

    1. Hunter KU, Lee OE, Lyden TH, et al. Aspiration pneumonia after chemo-intensity-modulated radiation therapy of oropharyngeal carcinoma and its clinical and dysphagia-related predictors. Head Neck 2014;36(1):120–125. - PMC - PubMed
    1. Xu B, Boero IJ, Hwang L, et al. Aspiration pneumonia after concurrent chemoradiotherapy for head and neck cancer. Cancer 2015;121(8):1303–1311. - PMC - PubMed
    1. Hunter KU, Schipper M, Feng FY, et al. Toxicities affecting quality of life after chemo-IMRT of oropharyngeal cancer: prospective study of patient-reported, observer-rated, and objective outcomes. Int J Radiat Oncol Biol Phys 2013;85(4):935–940. - PMC - PubMed
    1. Goepfert RP, Fuller CD, Gunn GB, et al. Symptom burden as a driver of decisional regret in long-term oropharyngeal carcinoma survivors. Head Neck 2017;39(11):2151–2158. - PubMed
    1. Beadle BM, Liao KP, Giordano SH, et al. Reduced feeding tube duration with intensity-modulated radiation therapy for head and neck cancer: A Surveillance, Epidemiology, and End Results-Medicare Analysis. Cancer 2017;123:283–293. - PMC - PubMed

Publication types