{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T10:23:12Z","timestamp":1778926992046,"version":"3.51.4"},"reference-count":41,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,1,2]],"date-time":"2021-01-02T00:00:00Z","timestamp":1609545600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psycho-Oncology"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Problem alcohol use in persons with head and neck cancer (HNC) is associated with poor outcomes, including survival. Some evidence suggests that individuals living in rural areas may be at greater risk of problem alcohol use. The present exploratory cross\u2010sectional study sought to examine problem alcohol use at diagnosis in a sample of HNC patients by rural versus urban status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Self\u2010reported problem alcohol use as measured by the Short Michigan Alcoholism Screening Test (SMAST) was examined in rural and urban HNC patients at diagnosis (<jats:italic>N<\/jats:italic>\u00a0=\u00a0454). Multivariable linear regression analysis was conducted to examine correlates of problem alcohol use. Subgroup analyses examined HNC\u2010specific health\u2010related quality of life (HRQOL) by problem drinking status at diagnosis and 3\u2010 and 12\u2010month postdiagnosis in rural patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Multivariable linear regression analysis controlling for age, cancer site, cancer stage, depressive symptoms at diagnosis, and tobacco use at diagnosis indicated that rural residence was significantly associated with SMAST scores at diagnosis such that rural patients were more likely to report higher scores (<jats:italic>\u00df<\/jats:italic>\u00a0=\u00a00.095, sr<jats:sup>2<\/jats:sup>\u00a0=\u00a00.010, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.04). Covariate\u2010adjusted subgroup analyses suggest that rural patients with self\u2010reported problem alcohol use may exhibit deficits in HNC\u2010specific HRQOL at diagnosis and 3\u2010 and 12\u2010month postdiagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>HNC patients should be screened for problem alcohol use at diagnosis and counseled regarding the deleterious effects of continued drinking during treatment and beyond. Because access to treatment and referral options may be lacking in rural areas, additional ways of connecting rural patients to specialty care should be explored.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pon.5616","type":"journal-article","created":{"date-parts":[[2020,12,21]],"date-time":"2020-12-21T11:40:55Z","timestamp":1608550855000},"page":"708-715","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Problem alcohol use among rural head and neck cancer patients at diagnosis: Associations with health\u2010related quality of life"],"prefix":"10.1002","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5863-3420","authenticated-orcid":false,"given":"M. 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