Health Care Utilisation and Unmet Needs in Survivors of Head and Neck Cancer in Regional Australia: A Cross-Sectional Survey

Psychooncology. 2025 Jan;34(1):e70056. doi: 10.1002/pon.70056.

Abstract

Background: The post-treatment survivorship period marks the transition away from acute care and poses distinct challenges for individuals with head and neck cancer (HNC). This can be especially challenging for people in regional areas who travel long distances to access care and experience unique challenges in accessing health services.

Aim: To investigate unmet needs and healthcare utilisation of survivors of HNC in regional areas.

Methods: Invitations were sent to 619 survivors of HNC living in rural New South Wales, Australia, who were 1-15 years post-treatment. Participants self-reported unmet survivorship needs and the strength of these needs using the Cancer Survivors' Unmet Needs Measure. Health care utilisation over the preceding 12 months was collected using an investigator-designed questionnaire.

Results: One hundred and seventeen responses were received (19% response rate). Participants were predominantly male (65%), had oropharynx cancer (52%), with mean age of 70.2 years. Some 54% of participants reported at least one unmet need, and 40% rated these unmet needs as 'strong'. Top unmet needs included concern about recurrence (24%), access to local services (15%), and financial support (15%). 94% of participants reported seeing their GP, while 62% visited a dental clinic; only 10% sought professional psychosocial support despite prevalent unmet needs.

Conclusion: Rural survivors of HNC in Australia have substantial unmet psychosocial needs yet demonstrate low utilisation of professional psychosocial support. This may reflect the limited availability or accessibility of services for this population, which could be addressed with shared models of care utilising both GP-led and telehealth services.

Keywords: cancer; head and neck cancer; healthcare utilisation; neoplasm; oncology; rural health; unmet needs.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Australia
  • Cancer Survivors* / psychology
  • Cancer Survivors* / statistics & numerical data
  • Cross-Sectional Studies
  • Female
  • Head and Neck Neoplasms* / psychology
  • Head and Neck Neoplasms* / therapy
  • Health Services Accessibility* / statistics & numerical data
  • Health Services Needs and Demand* / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Needs Assessment
  • New South Wales
  • Patient Acceptance of Health Care* / statistics & numerical data
  • Rural Population / statistics & numerical data
  • Surveys and Questionnaires