Cancer survivorship care among head and neck cancer patients living in rural and urban locations
8 affiliations
- 1UTHealth Houston Cizik School of Nursing, 6901 Bertner Ave, Houston, TX 77030 USA
- 2Tulane University, 6823 St. Charles Ave, New Orleans, LA 70118 USA
- 3UTHealth Houston D. Bradley McWilliams School of Biomedical Informatics, 7000 Fannin St, Houston, TX 77030 USA
- 4UTHealth Houston McGovern School of Medicine, 6400 Fannin St #2700, Houston, TX 77030 USA
- 5Department of Physical Medicine and Rehabilitation, UTHealth Houston McGovern School of Medicine, 1133 John Freeman Blvd. #JJL 285, Houston, TX 77030-3405 USA
- 6UTHealth Houston D. Bradley McWilliams School of Biomedical Informatics, 7000 Fannin St #600, Houston, TX 77030 USA
- 7NYU Meyers College of Nursing, 433 First Ave, New York, NY 10010 USA
- 8Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA 19111 USA
Abstract
Purpose: National Standards for Cancer Survivorship Care (i.e., survivorship standards) were developed as policy, process, and assessment standards to guide quality of survivorship care across all cancer settings. This descriptive study uses two methods to provide a picture of the alignment of care for patients with head and neck cancer (HNC) with survivorship standards in an academic health care system in Southeast Texas.
Methods: One method consisted of an anonymous survey of 15 HNC providers’ perceptions of alignment of survivorship standards with HNC. A modified kappa score for each standard was computed as proportion of participants’ agreement that the standard was relevant to the institutions’ HNC care. Scores ranged from 1 (highly relevant) to 0 (not relevant). The second method analyzed encounters over a 1-year period after diagnosis using electronic health record (EHR) data of 438 patients with HNC from the same institution. Statistical analysis included descriptive statistics and generalized linear models.
Results: Modified kappa scores showed the institution’s processes to provide HNC survivorship services were more aligned with survivorship standards (process = 0.60) than institutional policies or assessments (policies = 0.28; assessments = 0.29). EHR data analysis found HNC survivorship services consisted of nearly ¼ of encounters but concentrated in specialist and rehabilitation survivorship care.
Conclusion: The study’s cross-cutting themes include need for policies and assessments that increase EHR documentation of HNC survivorship care.
Implications for Cancer Survivors: The survivorship standards may be useful in developing clinical and informatics infrastructure needed to advance the quality of HNC survivorship care.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s11764-026-02129-8.
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BibTeX
@article{cleave2026cancer,
title = {{Cancer survivorship care among head and neck cancer patients living in rural and urban locations}},
author = {Janet H. Van Cleave and Ingrid Soares Henke Fortes and Jennifer A. Rodriguez and Alejandro Araya and Ron J. Karni and Carolina Gutiérrez and Susan H. Fenton and Dena Schulman-Green and Sahiti Myneni and Yang Gong and Kunal S. Jain and Brian L. Egleston},
journal = {Journal of Cancer Survivorship},
year = {2026},
month = oct,
doi = {10.1007/s11764-026-02129-8},
url = {https://doi.org/10.1007/s11764-026-02129-8},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Cancer survivorship care among head and neck cancer patients living in rural and urban locations
AU - Janet H. Van Cleave
AU - Ingrid Soares Henke Fortes
AU - Jennifer A. Rodriguez
AU - Alejandro Araya
AU - Ron J. Karni
AU - Carolina Gutiérrez
AU - Susan H. Fenton
AU - Dena Schulman-Green
AU - Sahiti Myneni
AU - Yang Gong
AU - Kunal S. Jain
AU - Brian L. Egleston
PY - 2026
DA - 2026/10/01
JO - Journal of Cancer Survivorship
DO - 10.1007/s11764-026-02129-8
UR - https://doi.org/10.1007/s11764-026-02129-8
AB - Purpose: National Standards for Cancer Survivorship Care (i.e., survivorship standards) were developed as policy, process, and assessment standards to guide quality of survivorship care across all cancer settings. This descriptive study uses two methods to provide a picture of the alignment of care for patients with head and neck cancer (HNC) with survivorship standards in an academic health care system in Southeast Texas. Methods: One method consisted of an anonymous survey of 15 HNC providers’ perceptions of alignment of survivorship standards with HNC. A modified kappa score for each standard was computed as proportion of participants’ agreement that the standard was relevant to the institutions’ HNC care. Scores ranged from 1 (highly relevant) to 0 (not relevant). The second method analyzed encounters over a 1-year period after diagnosis using electronic health record (EHR) data of 438 patients with HNC from the same institution. Statistical analysis included descriptive statistics and generalized linear models. Results: Modified kappa scores showed the institution’s processes to provide HNC survivorship services were more aligned with survivorship standards (process = 0.60) than institutional policies or assessments (policies = 0.28; assessments = 0.29). EHR data analysis found HNC survivorship services consisted of nearly ¼ of encounters but concentrated in specialist and rehabilitation survivorship care. Conclusion: The study’s cross-cutting themes include need for policies and assessments that increase EHR documentation of HNC survivorship care. Implications for Cancer Survivors: The survivorship standards may be useful in developing clinical and informatics infrastructure needed to advance the quality of HNC survivorship care. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s11764-026-02129-8.
SN - 1932-2259
SN - 1932-2267
ER -