Patient-reported symptoms in the detection of head and neck cancer recurrence : a systematic review

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Hulse, Kate and Hurley, Rhona and Lowit, Anja and Maguire, Roma and Paterson, Claire and Douglas, Catriona (2025) Patient-reported symptoms in the detection of head and neck cancer recurrence : a systematic review. Frontiers in Oncology, 15. 1632592. ISSN 2234-943X (https://doi.org/10.3389/fonc.2025.1632592)

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Abstract

Introduction: Patient-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. Methods: A 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. Results: Twenty 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. Conclusion: The 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.

ORCID iDs

Hulse, Kate ORCID logoORCID: https://orcid.org/0000-0003-2445-0279, Hurley, Rhona, Lowit, Anja ORCID logoORCID: https://orcid.org/0000-0003-0842-584X, Maguire, Roma ORCID logoORCID: https://orcid.org/0000-0001-7935-3447, Paterson, Claire and Douglas, Catriona;
CORE (COnnecting REpositories)