Advancing Education, Research, and Quality of Care for the Head and Neck oncology patient.
Objectives: This study summarizes three-year findings from an annual free head and neck cancer (HNC) screening event with a follow up phone survey six months following screening. We evaluate the effect of screening on participant knowledge of HNC, and we explore factors which may influence how participants seek care for head and neck complaints.
Study Design: Retrospective review of prospectively collected data from an annual community-based HNC screening in a mid-sized city.
Methods: During screening, participants completed a written questionnaire including demographics, risk factors, and signs or symptoms concerning for HNC. Participants then received brief education on HNC while undergoing a focused head and neck exam, followed by additional written follow up questions after screening. Six months following screening, follow-up phone surveys were administered to willing participants.
Results: Three hundred twenty-two screenings were completed, with 93 in 2022, 132 in 2023, and 97 in 2024. Participants were majority female (61.3% in 2022, 55.3% in 2023, and 59.8% in 2024) and African American (69.9% in 2022, 78.0% in 2023, and 63.9% in 2024) across all years. Mean age was 52.1 years in 2022, 52.1 in 2023, and 57.9 in 2024. 34.4% in 2022, 32.6% in 2023, and 40.2% in 2024 reported income less than then the federal poverty level. 34.4% in 2022, 25.0% in 2023, and 34.0% in 2024 reported less than an undergraduate education. Current tobacco use was reported by 10.8% in 2022, 10.6% in 2023, and 10.3% in 2024. When asked about human papillomavirus positivity, many participants were unsure or did not answer (95.7% in 2022, 93.9% in 2023, and 94.8% in 2024). 25.8% of participants felt the COVID pandemic had made it more difficult to be seen due to reduced doctors’ availability and 22.6% felt it had caused a preference for telehealth appointments in 2022, however this decreased to 9.1% and 9.1% in 2023, and 11.3% and 8.2% 2024. Immediately following screening, 73.1% in 2022, 86.4% in 2023, and 69.1% in 2024 reported increased awareness of HNC. Follow-up phone surveys at six months were completed by 13 participants in 2022, 34 participants in 2023, and 28 participants in 2024. At six month follow up, 92.3% in 2022, 76.5% in 2023, and 75.0% in 2024 reported increased awareness of HNC.
Conclusions: In our city, community-based HNC screening tended to attract a majority of African Americans and many of low socioeconomic status, reflecting some risk factors for HNC. On the other hand, there was also a female predominance across all years and a low smoking rate. Most participants did not seem to be aware of human papillomavirus, much less its role as a risk factor for HNC. The COVID pandemic seemed to present less of a barrier to healthcare with time from the pandemic. Screening provided an opportunity for participant education, with a majority reporting increased awareness of HNC immediately following screening. Furthermore, this self-reported increased awareness seemed to persist at six month follow up.