Prevalence of oral fungal colonization and associated factors in patients with head and neck cancer at four tertiary hospitals in Hanoi

Oral fungal colonization - most commonly caused by Candida species - and oral candidiasis are frequently observed in patients with head and neck cancer, particularly among those undergoing concurrent chemoradiotherapy. To determine the prevalence of oral fungal colonization in patients with head and neck cancer and to identify associated factors. A cross-sectional study was conducted from December 2020 to December 2024 among 156 patients with head and neck cancer treated at four tertiary hospitals in Hanoi: Military Hospital 103, Military Central Hospital 108, Hanoi Oncology Hospital, and the Central Otorhinolaryngology Hospital. Oral fungal colonization was assessed using direct microscopy and ChromAgar™ Candida culture methods. Clinical and demographic information was obtained using pre-designed research forms developed for research purposes. Univariate and multivariate logistic regression analyses were performed to identify factors associated with oral fungal carriage. The results shown that among 156 patients, 52.56% had oral fungal colonization, all caused by yeast species. Candida albicans and non-C. albicans species accounted for 75.61% and 32.93%, respectively, indicating C. albicans predominance. Patients receiving concurrent chemoradiotherapy had a 2.07 fold higher risk of oral candidiasis compared to those not receiving this combined treatment (95% CI: 1.05-4.09; p = 0.037). Oral fungal colonization is highly prevalent among patients with head and neck cancer, particularly those undergoing concurrent chemoradiotherapy. These findings emphasize the importance of routine monitoring and timely management of oral candidiasis to alleviate symptoms and improve quality of life.