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 Jun;160(6):941-954.
doi: 10.1177/0194599819829018. Epub 2019 Feb 12.

A Systematic Review of Patient-Reported Outcome Measures Assessing Body Image Disturbance in Patients with Head and Neck Cancer

Mark A Ellis  1 , Katherine R Sterba  2   3 , Emily A Brennan  1 , Stacey Maurer  2   4 , Elizabeth G Hill  2   3 , Terry A Day  1 , Evan M Graboyes  1   2
Affiliations

A Systematic Review of Patient-Reported Outcome Measures Assessing Body Image Disturbance in Patients with Head and Neck Cancer

Mark A Ellis et al. Otolaryngol Head Neck Surg. 2019 Jun.

Abstract

Objective: To synthesize published literature describing the severity of body image disturbance (BID) in patients with head and neck cancer (HNC) over time, its psychosocial and functional associations, and treatment strategies as assessed by patient-reported outcome measures (PROMs).

Data source: PubMed/MEDLINE, Scopus, PsycINFO, Web of Science, and Google Scholar.

Review methods: A systematic review of the English-language literature was performed to identify studies of BID in patients with HNC using psychometrically validated PROMs to assess (1) severity of BID over time, (2) psychosocial and functional associations, and (3) management strategies.

Results: A total of 17 studies met inclusion criteria. BID was assessed via 10 different PROMs, none of which were HNC-specific measures of BID. Two of 2 longitudinal studies (100%) reported that BID improved from pretreatment to posttreatment, and 2 of 3 longitudinal studies (67%) showed that the severity of BID decreased over time as survivors got further out from treatment. Seven of 17 studies (41%) described negative functional and psychosocial associations with BID, although study methodology limited conclusions about cause and effect. None of the studies assessing interventions to manage BID (0/2, 0%) demonstrated an improvement in BID relative to control.

Conclusion: BID in patients with HNC has negative functional and psychosocial associations and lacks evidence-based treatment. Research is limited by the lack of an HNC-specific BID PROM. Further research should address knowledge gaps related to the lack of an HNC-specific BID PROM, longitudinal course of BID in patients with HNC, confusion with regards to risk factors and outcomes, and lack of prevention and treatment strategies.

Keywords: body image disturbance; head and neck cancer; patient reported outcome measures; systematic review.

PubMed Disclaimer

Conflict of interest statement

Disclosures

Competing interests: Terry A. Day, Olympus (advisory board).

Figures

Figure 1.
Figure 1.
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram. BID, body image disturbance; HNC, head and neck cancer; PROM, patient-reported outcome measure; QOL, quality of life.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin. 2005;55:74–108. - PubMed
    1. Jansen F, Snyder CF, Leemans CR, Verdonck—de Leeuw IM. Identifying cutoff scores for the EORTC QLQ-C30 and the head and neck cancer—specific module EORTC QLQ-H&N35 representing unmet supportive care needs in patients with head and neck cancer. Head Neck. 2016;38(suppl 1):E1493–E1500. - PubMed
    1. Murphy BA, Ridner S, Wells N, Dietrich M. Quality of life research in head and neck cancer: a review of the current state of the science. Crit Rev Oncol. 2007;62:251–267. - PubMed
    1. De Boer MF, McCormick LK, Pruyn JF, Ryckman RM, van den Borne BW. Physical and psychosocial correlates of head and neck cancer: a review of the literature. Otolaryngol Head Neck Surg. 1999;120:427–436. - PubMed
    1. Fingeret MC, Yuan Y, Urbauer D, Weston J, Nipomnick S, Weber R. The nature and extent of body image concerns among surgically treated patients with head and neck cancer. Psychooncology. 2012;21:836–844. - PMC - PubMed

Publication types

MeSH terms