REVIEW article
Front. Oncol.
Sec. Head and Neck Cancer
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1632592
Patient-reported symptoms in the detection of head and neck cancer recurrence: a systematic review
Provisionally accepted
- 1University of Strathclyde School of Psychological Sciences and Health, Glasgow, United Kingdom
- 2Glasgow Head and Neck Cancer (GlaHNC) Research Group, Glasgow, United Kingdom
- 3University of Glasgow School of Medicine Dentistry and Nursing, Glasgow, United Kingdom
- 4University of Strathclyde Institute of Pharmacy and Biomedical Sciences, Glasgow, United Kingdom
- 5University of Strathclyde Department of Computer and Information Sciences, Glasgow, United Kingdom
- 6Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom
- 7Department of otolaryngology - head and neck surgery, Glasgow Royal Infirmary / Queen Elizabeth University Hospital, Glasgow, United Kingdom
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IntroductionPatient-initiated follow-up (PIFU) after treatment for head and neck cancer (HNC) relies on the signs and symptoms of recurrence being detectable by patients. We examine the evidence for patient-reported symptoms as an indicator of recurrence.MethodsA search was conducted via OvidMEDLINE and Embase (2010 to January 2024) plus sources of grey literature for studies which describe patient-reported symptoms and recurrent disease. Findings are reported as per PRISMA guidelines.ResultsTwenty studies were included which were highly heterogenous. The median sensitivity of patient-reported symptoms to detect recurrence is 47.3%. Median specificity, positive-predictive value (PPV) and negative-predictive value (NPV) were 79.3%, 9.3% and 98.0% respectively. New symptoms were generally reported at routine follow-up rather than expedited appointments. ConclusionThe high specificity and NPV of patient-reported symptoms means recurrence is unlikely in the absence of symptoms. Patient education and collection of prospective data through digital health technologies may increase the effectiveness of PIFU.
Keywords: head and neck cancer, Cancer morbidity, cancer recurrence, Patient reported outcome (PRO), Symptomatic recurrence
Received: 21 May 2025; Accepted: 30 May 2025.
Copyright: © 2025 Hulse, Hurley, Lowit, Maguire, Paterson and Douglas. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Kate Hulse, University of Strathclyde School of Psychological Sciences and Health, Glasgow, United Kingdom
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