# 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

## TL;DR

This study found that the COVID-19 pandemic did not significantly affect survival outcomes for head and neck cancer patients in the West of Scotland, despite more advanced cases being diagnosed in 2020.

## Contribution

The study provides evidence that the pandemic did not worsen short-term survival for HNSCC patients in a specific region.

## Key findings

- An increase in advanced-stage HNSCC diagnoses was observed in 2020 (67.5%, p = 0.01).
- No statistically significant difference in overall survival was found across the study period (p = 0.22).
- Socioeconomic inequalities persisted, with the poorest survival among the most deprived areas (p = 0.02).

## Abstract

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.

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.

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).

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.