Is free HNC screening impact greater in urban over suburban areas?

Free screenings for head and neck cancer (HNC) can increase early detection and also provide an opportunity to educate people about risk factors. But who is most likely to attend these screenings, and what do attendees know about head and neck cancer?

Among the people who attended free head and neck cancer screenings, those who live urban settings were more likely to be African American, current smoker, and have a history of treatment for some other cancer compared with people who lived in the suburbs, according to a new study from Henry Ford Hospital in Detroit, Michigan. The study also found that free screenings and related education were well-received in the racially diverse urban community of Detroit.

Head and neck cancers account for 3% of all cancer cases in the United States and can occur in the mouth, throat, larynx, esophagus, nasal passages, and salivary glands. Symptoms of head and neck cancer can be subtle. Warning signs include hoarseness, throat and ear pain lasting for more than 4 weeks, mouth sores that will not heal, and a lump in the neck. Tobacco and/or heavy alcohol use increases the risk of developing head and neck cancers, which is more common in people older than 40 years. Early detection saves lives and reduces the debilitating side effects associated with these cancers.

"Offering free head and neck cancer screenings to the community is a valuable resource that has a positive impact," said the lead author of the study, Tamer A. Ghanem, MD, PhD, director of the Head and Neck Oncology & Microvascular Surgery Division and division chief of the Department of Otolaryngology-Head and Neck Surgery at Henry Ford.

Ghanem and colleagues surveyed people age 23 to 85 years who attended Henry Ford's free head and neck cancer screening day in 2012 and 2013. A total of 98 people completed questionnaires on risk factors and knowledge about risk factors for head and neck cancer in a multiethnic urban area and a suburban area.

The study found that people living in an urban area reported more cumulative years consuming alcohol compared with those living in a suburban area. Urban patients were more willing to volunteer to promote awareness for head and neck cancer, and more urban patients felt that the free head and neck screening program increased their knowledge of head and neck cancer.

"Our study shows we have an opportunity to further enhance these screenings by including an evaluation of behavioral risks associated with head and neck cancer, and the patient's knowledge of those risk factors, such as smoking and alcohol use," Ghanem said. This study was published in Otolaryngology-Head and Neck Surgery (doi: 10.1177/0194599813496044a96).

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