Evidence map›Paper›PMID 42496537›Full record

ReviewEpidemiologia (Basel, Switzerland)2026

Socioeconomic Impact, Equity, and Sustainability in Head and Neck Cancer Surgery: A Structured Narrative Review.

Francesco Chiari, Salvatore Ferlito, Guglielmo Piccione, Rodolfo Modica, Mario Lentini, Giancarlo Carmelo Botto, Salvatore Maira, Skander Kedous, Carlos Chiesa-Estomba, Pierre Guarino and 2 more

Abstract readReview
In one paragraph

Review in Epidemiologia (Basel, Switzerland), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Francesco ChiariOtolaryngology Head and Neck Unit, "Santo Spirito" Hospital, 65121 Pescara, Italy.ORCID 0000-0001-5600-3938
Salvatore FerlitoDepartment of Medical, Surgical Sciences and Advanced Technologies G.F. Ingrassia, University of Catania, 95123 Catania, Italy.ORCID 0000-0001-7136-9698
Guglielmo PiccioneOspedale Maggiore Modica, ASP 7 di Ragusa, 97100 Ragusa, Italy.
Rodolfo ModicaOspedale Maggiore Modica, ASP 7 di Ragusa, 97100 Ragusa, Italy.ORCID 0009-0002-6908-7661
Mario LentiniOspedale Maggiore Modica, ASP 7 di Ragusa, 97100 Ragusa, Italy.ORCID 0009-0004-8127-5045
Giancarlo Carmelo BottoOspedale Maggiore Modica, ASP 7 di Ragusa, 97100 Ragusa, Italy.
Salvatore MairaDepartment of Medicine and Surgery, "Kore" University of Enna, 94100 Enna, Italy.ORCID 0009-0009-9740-2869
Skander KedousEars Nose and Throat, Head and Neck Surgery Department, Salah Azaiz Institute, Tunis 1000, Tunisia.
Carlos Chiesa-EstombaDepartment of Otolaryngology-Head and Neck Surgery, Donostia University Hospital, 20014 San Sebastián, Spain.ORCID 0000-0001-9454-9464
Pierre GuarinoOtolaryngology Head and Neck Unit, "Santo Spirito" Hospital, 65121 Pescara, Italy.ORCID 0000-0003-3796-9483
Jerome Rene LechienHead and Neck Research Committee, Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), 70123 Paris, France.ORCID 0000-0002-0845-0845
Antonino ManiaciOspedale Maggiore Modica, ASP 7 di Ragusa, 97100 Ragusa, Italy.ORCID 0000-0002-1251-0185

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSustainable head and neck cancer (HNC) surgery is challenged by environmental impact, workforce shortages, inequitable access to advanced techniques, and policy constraints. Addressing these areas is critical for equitable, high-quality care.

methodsThis structured narrative review synthesizes evidence on environmental sustainability, workforce development, technological innovation, health policy, and socioeconomic determinants in HNC surgery, without aiming to provide a systematic or exhaustive evidence synthesis. Sources included peer-reviewed literature, global workforce surveys, and international policy reports, with a focus on disparities between high-income countries (HICs) and low- and middle-income countries (LMICs).

resultsOperating rooms produce up to 70% of hospital solid waste and consume 3-6 times more energy than other units; reusable instruments and improved waste segregation can reduce carbon footprints by over 50%. Workforce shortages are severe in LMICs, where subspecialty training is scarce; global partnerships, bidirectional education, and simulation-based learning can expand local capacity. Telemedicine, artificial intelligence, and three-dimensional printing enhance surgical planning, training, and access but may widen disparities without equitable deployment. Policy tools-including diagnosis-related groups, bundled payments, and universal coverage-affect access and innovation uptake. Pandemic preparedness underscores the value of resilient systems with flexible staffing and telehealth integration.

conclusionsHNC surgery requires coordinated action across environmental, workforce, technological, socioeconomic, and policy domains; however, future systematic reviews are needed to comprehensively map the evidence base and assess its methodological quality. Embedding sustainability in clinical practice, ensuring equitable innovation access, and aligning reimbursement with high-value care can strengthen system resilience, improve outcomes, and support long-term surgical service viability.

Indexed as

3D printingartificial intelligenceglobal surgeryhead and neck cancerhealth policysustainabilitytelemedicineworkforce

Identifiers

PMID42496537
PMCPMC13398265

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.