Influence of clinicopathological and psychological factors on the smoking maintenance in head and neck cancer patients.
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Data
2021-08-31
Autores
Antunes, Ana Daniela Spínola da Silva [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
O tabagismo é fator de risco para vários tipos de câncer, dentre eles o câncer de cabeça e pescoço (CCP). Apesar do consumo de tabaco também estar relacionado com a ocorrência de segundo tumor primário e menor expectativa de vida, uma taxa considerável dos pacientes com CCP não consegue abandonar o hábito de fumar após o diagnóstico da doença. O objetivo deste estudo foi investigar a influência de fatores sociodemográficos, biocomportamentais, clinicopatológicos e psicológicos na manutenção ou cessação do tabagismo em pacientes com CCP após o tratamento da doença. O estudo foi composto por 71 pacientes com CCP que terminarm o tratamento oncológico há no mínimo 12 meses. As características demográficas, clinicopatológicas e biocomportamentais foram coletadas dos prontuários clínicos e o histórico de tabagismo ao longo do tratamento do câncer foi avaliado por meio de entrevista semi-estruturada. Sintomas de ansiedade e depressão foram avaliados no período pré-tratamento por meio do Inventário de Ansiedade de Beck (BAI) e Inventário de Depressão de Beck (BDI), respectivamente. Vinte e oito pacientes (39,4%) com CCP ainda fumavam imediatamente após o término do tratamento oncológico. Esta taxa aumentou para 43,7% quando o status do consumo de tabaco foi avaliado após 12 meses do final do tratamento. Na análise univariada foi encontrada associação entre variáveis sociodemográficos, clinicopatológicas e psicológicas e a alteração do habito do tabagismo em pacientes após tratamento de CCP. Análise de regressão logística mostrou que ter o tumor primário localizado em boca e a ocorrência do sintoma de tristeza mensurado pelo BDI antes do tratamento foram preditivos para a manutenção do tabagismo 12 meses após o final do tratamento oncológico. Sentimento de fracasso antes do tratamento oncológico foi fator de risco para maior dificuldade em parar de fumar, tanto logo depois do término do tratamento, quanto 12 meses depois. Os sintomas de ansiedade mensurados pelo BAI no período pré-tratamento não foram associados na análise multivariada à manutenção do tabagismo após o tratamento oncológico. Os resultados do presente estudo mostram que uma importante parcela de pacientes com CCP continuam fumando mesmo decorrido um ano do final do tratamento da doença, e que ter o tumor primário localizado em boca e a ocorrência de sintomas depressivos são preditivos para a manutenção do vício. Portanto, fatores clinicopatológicos e psicológicos devem ser considerados no planejamento do tratamento antitabagismo de pacientes com CCP.
Smoking is a risk factor for several types of cancer, including head and neck cancer (HNC). Although tobacco consumption is also related to the occurrence of second primary tumor and shorter life expectancy, a considerable rate of HNC patients is unable to quit smoking after the diagnosis of cancer. The aim of this study was to investigate the influence of sociodemographic, biobehavioral, clinicopathological and psychological factors on the smoking maintenance after HNC treatment. The study was composed of 71 HNC patients who had completed cancer treatment for at least 12 months. Demographic, clinicopathological and biobehavioral characteristics were collected from clinical records and smoking history throughout cancer treatment was assessed by a semi-structured interview. Anxiety and depression symptoms were assessed in the pre-treatment period using the Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI), respectively. Twenty-eight patients (39.4%) with HNC were still smoking immediately after the end of the oncological treatment. This rate increased to 43.7% when cigarette smoking status was assessed 12 months after the end of treatment. In the univariate analysis, an association was found between sociodemographic, clinicopathological and psychological variables and changes in the habit of smoking in patients after HNC treatment. Logistic regression analysis showed that having the primary tumor located in the oral cavity and the symptom of sadness measured by the BDI before treatment were predictive for the smoking maintenance 12 months after the end of cancer treatment. Feeling of failure before cancer treatment was a risk factor for higher difficulty in quitting smoking both immediately after the end of treatment and 12 months later. In the multivariate analysis anxiety symptoms in the pretreatment period were not associated with maintenance smoking after cancer treatment. The results of the current study show that a significant number of HNC patients continue to smoke even one year after the end of treatment, and that having the primary tumor located in the oral cavity and specific depressive symptoms are predictive for the maintenance of tobacco dependence. Therefore, clinicopathological and psychological factors should be considered in anti-smoking treatment of HNC patients.
Smoking is a risk factor for several types of cancer, including head and neck cancer (HNC). Although tobacco consumption is also related to the occurrence of second primary tumor and shorter life expectancy, a considerable rate of HNC patients is unable to quit smoking after the diagnosis of cancer. The aim of this study was to investigate the influence of sociodemographic, biobehavioral, clinicopathological and psychological factors on the smoking maintenance after HNC treatment. The study was composed of 71 HNC patients who had completed cancer treatment for at least 12 months. Demographic, clinicopathological and biobehavioral characteristics were collected from clinical records and smoking history throughout cancer treatment was assessed by a semi-structured interview. Anxiety and depression symptoms were assessed in the pre-treatment period using the Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI), respectively. Twenty-eight patients (39.4%) with HNC were still smoking immediately after the end of the oncological treatment. This rate increased to 43.7% when cigarette smoking status was assessed 12 months after the end of treatment. In the univariate analysis, an association was found between sociodemographic, clinicopathological and psychological variables and changes in the habit of smoking in patients after HNC treatment. Logistic regression analysis showed that having the primary tumor located in the oral cavity and the symptom of sadness measured by the BDI before treatment were predictive for the smoking maintenance 12 months after the end of cancer treatment. Feeling of failure before cancer treatment was a risk factor for higher difficulty in quitting smoking both immediately after the end of treatment and 12 months later. In the multivariate analysis anxiety symptoms in the pretreatment period were not associated with maintenance smoking after cancer treatment. The results of the current study show that a significant number of HNC patients continue to smoke even one year after the end of treatment, and that having the primary tumor located in the oral cavity and specific depressive symptoms are predictive for the maintenance of tobacco dependence. Therefore, clinicopathological and psychological factors should be considered in anti-smoking treatment of HNC patients.
Descrição
Palavras-chave
Neoplasias de cabeça e pescoço, Tabagismo, Ansiedade, Depressão, Head and neck neoplasm, Tobacco use disorder, Anxiety, Depression