Faculty Collaboration Database

A comparison of community-based and hospital-based head and neck cancer screening campaigns: identifying high-risk individuals and early disease. JAMA Otolaryngol Head Neck Surg 2013 Jun;139(6):568-73

Date

06/22/2013

Pubmed ID

23787414

DOI

10.1001/jamaoto.2013.3153

Scopus ID

2-s2.0-84879360384 (requires institutional sign-in at Scopus site)   13 Citations

Abstract

IMPORTANCE: An enduring challenge in the care of patients with head and neck cancer is identifying disease earlier. Appropriately designed screening campaigns are one proposed strategy.

OBJECTIVE: To determine whether a hospital-based or a community-based head and neck cancer (HNC) screening strategy is more effective in identifying high-risk individuals, signs and symptoms, and findings consistent with head and neck neoplasia.

DESIGN, SETTING, AND PARTICIPANTS: In this retrospective cohort analysis, data from HNC screening efforts held at a tertiary care medical center and at a local motorsports event were compared. Participants completed a questionnaire, and a focused physical examination was performed.

MAIN OUTCOMES AND MEASURES: Identification rates of high-risk individuals, signs and symptoms, and findings consistent with head and neck neoplasia.

RESULTS: The hospital-based and community-based efforts yielded 210 and 1380 individuals screened, respectively. The community-based screening events attracted a significantly greater proportion of participants with risk factors of HNC including male sex (P < .001), current tobacco use (P < .001), lifetime history of tobacco use (P = .03), smokeless tobacco use (P = .003), and current alcohol use (P = .04). The hospital-based screening events, however, attracted a statistically greater proportion of people reporting prior head and neck or otolaryngologic treatment (P < .001), history of cancer outside the head and neck (P < .001), and a greater median number of symptoms (P < .001) and examination findings (P < .001).

CONCLUSIONS AND RELEVANCE: These data suggest that the 2 screening models attract 2 fundamentally different types of participants, and those in both groups may benefit from screening, albeit for different reasons: one has a higher rate of risk factors, and early-stage HNC might be discovered while it is more readily treatable; the other has a higher rate of concerning signs, symptoms, and findings, and screening might be used to diagnose or rule out HNC.

Author List

Harris MS, Phillips DR, Sayer JL, Moore MG

Author

Michael S. Harris MD Associate Professor in the Otolaryngology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Aged
Aged, 80 and over
Alcohol Drinking
Child
Child, Preschool
Community Health Services
Early Detection of Cancer
Female
Head and Neck Neoplasms
Hospitals
Humans
Indiana
Male
Mass Screening
Middle Aged
Physical Examination
Retrospective Studies
Risk Assessment
Risk Factors
Sex Factors
Surveys and Questionnaires
Tobacco, Smokeless