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. 2026 Mar 4;4(1):8.
doi: 10.1038/s44276-026-00203-3.

The COVID-19 pandemic has not influenced survival outcomes of head and neck cancer squamous cell carcinomas in the West of Scotland: a retrospective cohort study

Craig D L Smith  1   2   3 , Alex D McMahon  4   5 , Gareth J Inman  5   6 , David I Conway  4   5 , Catriona M Douglas #  4   5   7 , Claire Paterson #  5   8
Affiliations

The COVID-19 pandemic has not influenced survival outcomes of head and neck cancer squamous cell carcinomas in the West of Scotland: a retrospective cohort study

Craig D L Smith et al. BJC Rep. .

Abstract

Background: The COVID-19 pandemic posed significant disruptions to healthcare worldwide. This study aimed to assess if the COVID-19 pandemic affected short-term survival outcomes of patients with head and neck cancer squamous cell carcinoma (HNSCC) in the west of Scotland.

Methods: A retrospective cohort analysis was conducted using regional centre data. Patients diagnosed with HNSCC during pre-pandemic (June-October 2019), intra-pandemic (June-October 2020) and post(peak)-pandemic (June-October 2022) were compared. Demographic, behavioural, clinical, and survival data were analysed using Kaplan-Meier curves, Cox-regression, and logistic-regression for stage at diagnosis.

Results: A total of 707 patients were included. While the 2020 cohort exhibited an increase in advanced-stage disease (67.5% p = 0.01), no statistically significant difference in overall survival was observed across the study period (p = 0.22). Cox-regression showed no associations between year of diagnosis and mortality, even after multivariable adjustment for confounders. Survival was strongly associated with age, performance status, stage, and HPV status among oropharynx cancers. Socioeconomic inequalities persisted, with the poorest survival among those from the most socioeconomically deprived areas (p = 0.02).

Conclusions: While an increase in advanced-stage HNSCC diagnoses was observed in the West of Scotland during 2020, short-term survival outcomes remained comparable to pre- and post-pandemic.

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Conflict of interest statement

Competing interests: The authors declare no competing interests. Ethical approval and consent to participate: Local clinical NHS Caldicott Guardian and University of Glasgow ethical approvals (Project number 200240340) were obtained for this cohort analysis of minimally identifiable, routinely consented, clinical data.

Figures

Fig. 1
Fig. 1
Kaplan-Meier Survival Curve (with Confidence Intervals) for patients diagnosed with Head and Neck Cancer in the west of Scotland during 2019 (n = 239, 130 events), 2020 (n = 237, 137 events) and 2022 (n = 231, 99 events)
Fig. 2
Fig. 2
Kaplan-Meier Survival Curve stratified by SIMD (Scottish Index of Multiple Deprivation) for patients diagnosed with Head and Neck Cancer in the west of Scotland among the 2020 cohort. SIMD 1 = 20% Most deprived, SIMD 5 = 20% Least deprived.
Fig. 3
Fig. 3
Kaplan-Meier survival curve for patients diagnosed with advanced stage (AJCC Stage III and IV) Head and Neck Cancer in the west of Scotland among the 2019, 2020 and 2022 cohorts.
See this image and copyright information in PMC

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