by A recent study conducted by researchers from the Johns Hopkins Kimmel Cancer Center and its Head and Neck Cancer Center reveals that the quality of care for patients with human papillomavirus (HPV)-related squamous cell cancers of the oropharynx (the back of the throat) may be compromised in community cancer centers. These findings, published in the Journal of the National Cancer Institute, are concerning as the shift towards community cancer centers for the treatment of this type of head and neck cancer could potentially have negative implications for patient survival.
The study examined data from over 20,000 patients with HPV-related oropharyngeal squamous cell cancers who were diagnosed and treated between 2010 and 2019. While about two-thirds of patients received care at academic cancer centers, the proportion of patients seeking treatment at community cancer centers increased from 24% in 2010 to 36% in 2019. If this trend continues, it is projected that up to 50% of patients with these rare cancers will be treated at community cancer centers by 2030.
The growing comfort of clinicians in community cancer centers in treating this type of cancer may explain the shift in patient care. However, the study found that the quality of care and survival rates in community cancer centers lag behind those in academic cancer centers. Patients treated in community cancer centers were less likely to receive recommended care such as surgery and more likely to receive radiation as the primary treatment. Consequently, their outcomes were negatively impacted.
Furthermore, the study revealed a divergence in survival rates between patients treated at academic centers and those treated at community centers in recent years. Between 2014 and 2017, about 87% of patients treated at academic cancer centers survived, compared to approximately 81% at community cancer centers.
These findings have significant implications for the future quality of care. The volume of patients treated at academic centers is instrumental in training the next generation of physicians. Additionally, if radiation becomes the primary mode of treatment at community centers, there will be an increased demand for radiation oncologists and multidisciplinary teams, which are vital for providing guideline-directed care to these patients.
The study also underlines the evidence that higher-volume treatment centers yield better outcomes compared to lower-volume centers. Academic centers that specialize in treating rare head and neck cancers are more likely to offer advanced surgical techniques, such as transoral robotic surgery, and are better equipped to provide multidisciplinary care and support services, leading to improved patient outcomes.
The research raises the question of whether it would be beneficial to concentrate care for HPV-related oropharyngeal squamous cell carcinomas at high-volume academic centers to optimize patient care. As the shift towards community cancer centers continues, it is crucial to further investigate the factors contributing to differences in survival outcomes for these patients.
In conclusion, the study emphasizes the potential drawbacks of community cancer centers in providing quality care and achieving favorable outcomes for patients with HPV-related squamous cell cancers of the oropharynx. It highlights the need for continued research, increased awareness, and potential reforms to ensure that patients with these types of head and neck cancers receive optimal treatment and care.
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