Adverse oral health in older adults with head and neck cancer (and oral potentially malignant disorders): a systematic review

Objective
This systematic review evaluated oral health, including oral health-related quality of life (OHRQoL), in older adults with head and neck cancer (HANC) or oral potentially malignant disorders (OPMDs). The PICO/PECO focus question for this study was: ‘What is the incidence/prevalence of adverse oral health (O) among people aged 60 years or older (P) who have been diagnosed with HANC or an OPMD (E), relative to people aged 60 years or older who have not been diagnosed with HANC or an OPMD, or younger people aged less than 60 years who have been diagnosed with HANC or an OPMD (C)?’

Methods
A comprehensive literature search was performed across PubMed, OVID Medline, CENTRAL and Embase, guided by the PICO/PECO framework. Publications from 1960 up to April 2025 were considered, yielding 1070 records for initial screening.

Results
A total of eight studies were included for analysis. A narrative review only was presented. Findings from the included studies demonstrated conflicting results. Two cross-sectional studies demonstrated better post-treatment OHRQoL across some domains for older patients with HANC than younger patients; however, this was contradicted by data from two prospective cohort studies which showed no differences in post-treatment OHRQoL between older and younger patients with a history of HANC. Findings from a different prospective cohort study demonstrated a linear relationship between HANC patients' age and the incidence of post-radiotherapy moderate–severe xerostomia. There were no data on oral health consequences among older adults with OPMDs.

Conclusions
This systematic review revealed inconclusive findings on the impact of HANC and OPMD on oral health in older adults.

PROSPERO Registration: CRD420251003419