{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T18:16:05Z","timestamp":1793643365744,"version":"4.5.1"},"reference-count":49,"publisher":"American Medical Association (AMA)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Otolaryngol Head Neck Surg"],"published-print":{"date-parts":[[2023,12,1]]},"abstract":"<jats:sec id=\"ab-ooi230060-4\"><jats:title>Importance<\/jats:title><jats:p>Cancer survivors are at a higher risk of developing hearing loss (HL) due to older age, chemotherapy, and radiotherapy. However, the prevalence of HL among US cancer survivors remains unknown. Additionally, there is a lack of uniform HL screening guidelines for this enlarging population.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi230060-5\"><jats:title>Objective<\/jats:title><jats:p>To estimate the prevalence of subjective HL and objective HL by audiometry test among cancer survivors and compare them with the general population as well as to assess the performance of subjective HL questions in detecting true (ie, audiometry-confirmed) HL.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi230060-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>In a cross-sectional design, adults between ages 20 and 80 years who had audiometry testing and responded to a hearing questionnaire from the National Health and Nutrition Examination Survey (2011-2012, 2015-2016, and 2017 to March 2020 prepandemic survey cycles) were selected. Data analysis was conducted from August 13, 2022, to July 26, 2023.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi230060-7\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>The weighted prevalence of subjective HL (troublesome hearing and tinnitus) and objective HL (speech-frequency HL and high-frequency HL) by audiometry were calculated. Analyses with \u03c7<jats:sup>2<\/jats:sup> testing and multiadjusted logistic regression models were used to compare HL between cancer survivors and the general population. To evaluate the performance of subjective HL questions as a tool to screen for objective HL by audiometry, areas under the curve were estimated using age- and gender-adjusted logistic regression.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi230060-8\"><jats:title>Results<\/jats:title><jats:p>Among the total 9337 participants (weighted n\u2009=\u200990\u202f098\u202f441; 51.2% women), 10.3% were cancer survivors. Compared with the general population, cancer survivors had a higher prevalence of troublesome hearing (adjusted odds ratio [AOR], 1.43; 95% CI, 1.11-1.84), tinnitus (AOR, 1.28; 95% CI, 0.94-1.74), speech-frequency HL (AOR, 1.43; 95% CI, 1.11-1.85), and high-frequency HL (AOR, 1.74; 95% CI, 1.29-2.34). When using the subjective HL tool and questioning  regarding whether the participants were having troublesome hearing and\/or tinnitus in screening for HL, the age- and gender-adjusted area under the curve was 0.88 in detecting speech-frequency HL and 0.90 in detecting high-frequency HL.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi230060-9\"><jats:title>Conclusion and Relevance<\/jats:title><jats:p>The findings of this study suggest that cancer survivors have a significantly higher prevalence of HL than the general population. Two subjective HL questions could potentially accurately identify those who have true HL and provide a simple and efficient screening tool for health care professionals. Cancer survivors and their families should be educated and encouraged to discuss hearing concerns, and health care professionals should facilitate raising awareness and provide early screening and timely referral when HL is identified.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamaoto.2023.2941","type":"journal-article","created":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T15:32:22Z","timestamp":1696519942000},"page":"1101","source":"Crossref","is-referenced-by-count":7,"title":["Subjective and Objective Hearing Loss Among US Adult Cancer Survivors"],"prefix":"10.1001","volume":"149","author":[{"given":"Qian","family":"Wang","sequence":"first","affiliation":[{"name":"University Hospitals Seidman Cancer Center, Cleveland, Ohio"},{"name":"Division of Hematology and Medical Oncology, Case Western Reserve University, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changchuan","family":"Jiang","sequence":"additional","affiliation":[{"name":"Division of Hematology & Oncology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi","family":"Wen","sequence":"additional","affiliation":[{"name":"Quality Operations, Mount Sinai Health System, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Xie","sequence":"additional","affiliation":[{"name":"University of Wisconsin-Milwaukee Joseph J Zilber School of Public Health, Milwaukee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yannan","family":"Li","sequence":"additional","affiliation":[{"name":"School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaning","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Ascension Providence Hospital, Southfield, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leila J.","family":"Mady","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery, The Johns Hopkins School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debora S.","family":"Bruno","sequence":"additional","affiliation":[{"name":"University Hospitals Seidman Cancer Center, Cleveland, Ohio"},{"name":"Division of Hematology and Medical Oncology, Case Western Reserve University, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giselle M. 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