Disease trajectories, place and mode of death in people with head and neck cancer: findings from the ‘Head and Neck 5000’ population-based prospective clinical cohort study

Catriona R Mayland, Kate Ingarfield, SIMON ROGERS, MARIA PAOLA DEY, Steven Thomas, Andrea Waylen, Sam D Leary, Miranda Pring, Katrina Hurley, Thomas Waterboer, Michael Pawlita, Andy Ness

Research output: Contribution to journalArticle

Abstract

Background: Few large studies describe initial disease trajectories and subsequent mortality in people with head and neck cancer. This is a necessary first step to identify the need for palliative care and associated services.
Aim: To analyse data from the Head and Neck 5000 study to present mortality, place and mode of death within 12 months of diagnosis.
Design: Prospective cohort study.
Participants: In total, 5402 people with a new diagnosis of head and neck cancer were recruited from 76 cancer centres in the United Kingdom between April 2011 and December 2014.
Results: Initially, 161/5402 (3%) and 5241/5402 (97%) of participants were treated with ‘non-curative’ and ‘curative’ intent respectively. Within 12 months, 109/161 (68%) in the ‘non-curative’ group died compared with 482/5241 (9%) in the ‘curative’ group. Catastrophic bleed was the terminal event for 10.4% and 9.8% of people in ‘non-curative’ and ‘curative’ groups respectively; terminal airway obstruction was recorded for 7.5% and 6.3% of people in the same corresponding groups. Similar proportions of people in both groups died in a hospice (22.9% ‘non-curative’; 23.5% ‘curative’) and 45.7% of the ‘curative’ group died in hospital.
Conclusions: In addition to those with incurable head and neck cancer, there is a small but significant ‘curative’ subgroup of people who may have palliative needs shortly following diagnosis. Given the high mortality, risk of acute catastrophic event and frequent hospital death, clarifying the level and timing of palliative care services engagement would help provide assurance as to whether palliative care needs are being met.
Original languageEnglish
JournalPalliative Medicine
Publication statusAccepted/In press - 7 Jan 2020

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Head and Neck Neoplasms
Palliative Care
Cohort Studies
Mortality
Population
Hospices
Airway Obstruction
Neck
Head
Prospective Studies
Clinical Studies
Neoplasms

Keywords

  • Pallitative Medicine
  • Cancer

Cite this

Mayland, Catriona R ; Ingarfield, Kate ; ROGERS, SIMON ; DEY, MARIA PAOLA ; Thomas, Steven ; Waylen, Andrea ; Leary, Sam D ; Pring, Miranda ; Hurley, Katrina ; Waterboer, Thomas ; Pawlita, Michael ; Ness, Andy. / Disease trajectories, place and mode of death in people with head and neck cancer: findings from the ‘Head and Neck 5000’ population-based prospective clinical cohort study. In: Palliative Medicine. 2020.
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title = "Disease trajectories, place and mode of death in people with head and neck cancer: findings from the ‘Head and Neck 5000’ population-based prospective clinical cohort study",
abstract = "Background: Few large studies describe initial disease trajectories and subsequent mortality in people with head and neck cancer. This is a necessary first step to identify the need for palliative care and associated services. Aim: To analyse data from the Head and Neck 5000 study to present mortality, place and mode of death within 12 months of diagnosis. Design: Prospective cohort study.Participants: In total, 5402 people with a new diagnosis of head and neck cancer were recruited from 76 cancer centres in the United Kingdom between April 2011 and December 2014. Results: Initially, 161/5402 (3{\%}) and 5241/5402 (97{\%}) of participants were treated with ‘non-curative’ and ‘curative’ intent respectively. Within 12 months, 109/161 (68{\%}) in the ‘non-curative’ group died compared with 482/5241 (9{\%}) in the ‘curative’ group. Catastrophic bleed was the terminal event for 10.4{\%} and 9.8{\%} of people in ‘non-curative’ and ‘curative’ groups respectively; terminal airway obstruction was recorded for 7.5{\%} and 6.3{\%} of people in the same corresponding groups. Similar proportions of people in both groups died in a hospice (22.9{\%} ‘non-curative’; 23.5{\%} ‘curative’) and 45.7{\%} of the ‘curative’ group died in hospital. Conclusions: In addition to those with incurable head and neck cancer, there is a small but significant ‘curative’ subgroup of people who may have palliative needs shortly following diagnosis. Given the high mortality, risk of acute catastrophic event and frequent hospital death, clarifying the level and timing of palliative care services engagement would help provide assurance as to whether palliative care needs are being met.",
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author = "Mayland, {Catriona R} and Kate Ingarfield and SIMON ROGERS and DEY, {MARIA PAOLA} and Steven Thomas and Andrea Waylen and Leary, {Sam D} and Miranda Pring and Katrina Hurley and Thomas Waterboer and Michael Pawlita and Andy Ness",
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Mayland, CR, Ingarfield, K, ROGERS, SIMON, DEY, MARIAPAOLA, Thomas, S, Waylen, A, Leary, SD, Pring, M, Hurley, K, Waterboer, T, Pawlita, M & Ness, A 2020, 'Disease trajectories, place and mode of death in people with head and neck cancer: findings from the ‘Head and Neck 5000’ population-based prospective clinical cohort study', Palliative Medicine.

Disease trajectories, place and mode of death in people with head and neck cancer: findings from the ‘Head and Neck 5000’ population-based prospective clinical cohort study. / Mayland, Catriona R; Ingarfield, Kate; ROGERS, SIMON; DEY, MARIA PAOLA; Thomas, Steven ; Waylen, Andrea; Leary, Sam D; Pring, Miranda; Hurley, Katrina; Waterboer, Thomas; Pawlita, Michael; Ness, Andy.

In: Palliative Medicine, 07.01.2020.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Disease trajectories, place and mode of death in people with head and neck cancer: findings from the ‘Head and Neck 5000’ population-based prospective clinical cohort study

AU - Mayland, Catriona R

AU - Ingarfield, Kate

AU - ROGERS, SIMON

AU - DEY, MARIA PAOLA

AU - Thomas, Steven

AU - Waylen, Andrea

AU - Leary, Sam D

AU - Pring, Miranda

AU - Hurley, Katrina

AU - Waterboer, Thomas

AU - Pawlita, Michael

AU - Ness, Andy

PY - 2020/1/7

Y1 - 2020/1/7

N2 - Background: Few large studies describe initial disease trajectories and subsequent mortality in people with head and neck cancer. This is a necessary first step to identify the need for palliative care and associated services. Aim: To analyse data from the Head and Neck 5000 study to present mortality, place and mode of death within 12 months of diagnosis. Design: Prospective cohort study.Participants: In total, 5402 people with a new diagnosis of head and neck cancer were recruited from 76 cancer centres in the United Kingdom between April 2011 and December 2014. Results: Initially, 161/5402 (3%) and 5241/5402 (97%) of participants were treated with ‘non-curative’ and ‘curative’ intent respectively. Within 12 months, 109/161 (68%) in the ‘non-curative’ group died compared with 482/5241 (9%) in the ‘curative’ group. Catastrophic bleed was the terminal event for 10.4% and 9.8% of people in ‘non-curative’ and ‘curative’ groups respectively; terminal airway obstruction was recorded for 7.5% and 6.3% of people in the same corresponding groups. Similar proportions of people in both groups died in a hospice (22.9% ‘non-curative’; 23.5% ‘curative’) and 45.7% of the ‘curative’ group died in hospital. Conclusions: In addition to those with incurable head and neck cancer, there is a small but significant ‘curative’ subgroup of people who may have palliative needs shortly following diagnosis. Given the high mortality, risk of acute catastrophic event and frequent hospital death, clarifying the level and timing of palliative care services engagement would help provide assurance as to whether palliative care needs are being met.

AB - Background: Few large studies describe initial disease trajectories and subsequent mortality in people with head and neck cancer. This is a necessary first step to identify the need for palliative care and associated services. Aim: To analyse data from the Head and Neck 5000 study to present mortality, place and mode of death within 12 months of diagnosis. Design: Prospective cohort study.Participants: In total, 5402 people with a new diagnosis of head and neck cancer were recruited from 76 cancer centres in the United Kingdom between April 2011 and December 2014. Results: Initially, 161/5402 (3%) and 5241/5402 (97%) of participants were treated with ‘non-curative’ and ‘curative’ intent respectively. Within 12 months, 109/161 (68%) in the ‘non-curative’ group died compared with 482/5241 (9%) in the ‘curative’ group. Catastrophic bleed was the terminal event for 10.4% and 9.8% of people in ‘non-curative’ and ‘curative’ groups respectively; terminal airway obstruction was recorded for 7.5% and 6.3% of people in the same corresponding groups. Similar proportions of people in both groups died in a hospice (22.9% ‘non-curative’; 23.5% ‘curative’) and 45.7% of the ‘curative’ group died in hospital. Conclusions: In addition to those with incurable head and neck cancer, there is a small but significant ‘curative’ subgroup of people who may have palliative needs shortly following diagnosis. Given the high mortality, risk of acute catastrophic event and frequent hospital death, clarifying the level and timing of palliative care services engagement would help provide assurance as to whether palliative care needs are being met.

KW - Pallitative Medicine

KW - Cancer

M3 - Article

JO - Palliative Medicine

JF - Palliative Medicine

SN - 0269-2163

ER -