Is health insurance a risk factor for suicidal ideation among adults suffering from head and neck cancer in the US?

OBJECTIVE: The purpose of the following study was to determine whether health insurance impacts the risk of suicidal ideation among patients with head and neck cancer (HNC). STUDY DESIGN: A retrospective cohort study was completed using the 2016 to 2018 National Inpatient Sample on adult patients (≥18 years) with HNC. The primary predictor was health insurance. The primary outcome was suicidal ideation. Multivariate logistic regression was employed to identify risk factors for the primary outcome variable. RESULTS: The final study sample consisted of 29 231 patients with HNC. Not controlling for confounders, being a Medicaid patient was a risk factor for suicidal ideation (odds ratio [OR] 2.44; P < .01). However, after controlling for confounders, Medicaid was no longer a risk factor or suicidal ideation (OR 1.52; P = .190). Patients with alcohol dependence/abuse (OR 2.94; P < .01) and depression (OR 8.30; P < .01) were each more likely to experience suicidal ideation. CONCLUSIONS: Medicaid insurance was not a risk factor for suicidal ideation in our study. Depression and alcohol dependence/abuse were each risk factors for suicidal ideation. Oral cancer and oropharyngeal cancer each decreased the risk for suicidal ideations.

Quality of life in patients with oral potentially malignant disorders: oral lichen planus and oral epithelial dysplasia.

OBJECTIVE: The aim of this study was to evaluate and compare quality of life (QoL) parameters in patients with oral potential malignant disorders (OPMDs), namely, oral lichen planus (OLP) and oral epithelial dysplasia (OED). STUDY DESIGN: A cross-sectional study was completed at the oral maxillofacial surgery/oral medicine practices at University of Pennsylvania. Patients with clinical and histopathologic confirmation of OLP or OED from January to June 2021 were included in the study. The primary predictor variable was the OPMD type. The primary outcome variable was the score of 3 separate surveys: the Chronic Oral Mucosal Disease Questionnaire-26 (COMDQ-26), Oral Potential Malignant Disorder QoL Questionnaire (OPMDQoL), and Hospital Anxiety and Depression Scale. Multiple linear regression was used to determine independent predictors of increased/decreased questionnaire scores. RESULTS: The final study sample consisted of 100 patients:53 patients had OLP (53.0%), 39 patients had OED (39.0%), and 8 patients had OLP with OED (8.0%). Relative to OED, OLP added 15.7 points to the COMDQ-26 survey score (P < .001). Relative to OED, OLP added 8.9 points to the OPMDQoL survey score (P = .003). CONCLUSIONS: Oral lichen planus shows significantly poorer QoL specifically within the COMD-26 and OPMDQoL questionnaires, compared with OED. Additionally, patients with OPMDs aged 40 to 64 years were independently associated with higher COMD-26 scores compared with older patients (>65 years).