Head and Neck Cancer Survivorship Care

Publication Date: December 19, 2019
Last Updated: March 14, 2022

Recommendations

Surveillance for HNC recurrence

History and physical

It is recommended that primary care clinicians:
a) should receive guidance from the treating oncology team regarding the individualized follow up plan
b) should work with the treating oncology team to ensure that a detailed cancer-related history and physical examination be conducted every 1 to 3 months for the first year after primary treatment, every 2 to 6 months in the second year, every 4 to 8 months in years 3 to 5, and annually after 5 years
c) should confirm continued follow-up with otolaryngologist or HNC specialist for HN-focused examination based on review of individualized plan with the treating team.
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Surveillance education

It is recommended that primary care clinicians:
a) should receive guidance from the treating oncology team regarding signs and symptoms of local and distant recurrences
b) assure that HNC survivors receive this information from their treating team
c) should refer HNC survivors to an HNC specialist if signs and symptoms of local or distant recurrences are present.
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Screening and early detection of second primary cancers

It is recommended that primary care clinicians:
a) should perform routine age-and gender-appropriate cancer screening of HNC survivors for other cancers as they would for patients in the general population by adhering to guidelines such as the ACS Early Detection Recommendations (cancer.org/professionals; LOE = 0) and the US Preventive Services Task Force
b) should screen HNC survivors for lung cancer according to ASCO or NCCN14 recommendations for annual lung cancer screening with clinically indicated low-dose computed tomography for high-risk patients based on smoking history (LOE = 2A)
c) should screen HNC survivors for another HN and esophageal cancer as they would for patients of increased risk.
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Assessment and Management of Physical and Psychosocial Long-Term and Late Effects of HNC and Its Treatment

In general, the ASCO Panel believes longterm and late effects should be assessed with history and physical examinations and managed with the collaboration of a multispecialty, multidisciplinary HNC team.
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Health Promotion Information

It is recommended that primary care clinicians:
(a) should assess the information needs of the HNC survivor related to HNC and its treatment, adverse effects, other health concerns, and available support services (LOE = 0)
(b) should provide or refer HNC survivors to appropriate resources to meet identified needs (LOE = 0).
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Care Coordination and Practice Implications

It is recommended that primary care clinicians should consult with the oncology team and obtain a treatment summary and survivorship care plan (LOE = 0, III).
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Recommendation Grading

Overview

Title

Head and Neck Cancer Survivorship Care

Authoring Organization

American Society of Clinical Oncology

Publication Month/Year

December 19, 2019

Last Updated Month/Year

July 5, 2023

Supplemental Implementation Tools

Document Type

Guideline

External Publication Status

Published

Country of Publication

US

Target Patient Population

Adult post-treatment head and neck cancer (HNC) survivors

Inclusion Criteria

Female, Male, Adult, Older adult

Health Care Settings

Ambulatory, Hospital, Long term care, Outpatient

Intended Users

Speech language pathologist, psychologist, dietician nutritionist, dentist, counselor, nurse, nurse practitioner, physician, physician assistant

Scope

Counseling, Management

Diseases/Conditions (MeSH)

D006258 - Head and Neck Neoplasms

Keywords

head and neck cancer, human papillomavirus (HPV)