Otolaryngologists Find Creative Ways To Offer Cancer Screening to High-Risk Populations

But one of the things we realized is that of the approximately 140 patients who show up every year, most are health conscious and have access to health care already, said Cherie-Ann Nathan, MD, Professor and Vice-Chairman of Otolaryngology-Head and Neck Surgery at LSU’s Health Sciences Center and Director of Head and Neck Surgical Oncology at the Feist-Weiller Cancer Center. Participants are self-selected and tend to be highly motivated and generally on top of any health problems they might have, she said.

Most academic-based programs market the oral, head and neck cancer screening to local audiences, and whoever wants to be screened shows up at an office clinic, said Michael M. Johns III, MD, Assistant Professor of Otolaryngology at Emory University and Director of the Emory Voice Center in Atlanta. The problem is that the people coming in for the screening aren’t those who are at high risk, he said.

Reaching High-Risk Populations

The solution to the problem is actively reaching out to the high-risk community, said Dr. Gourin, adding that a history of tobacco use, alcohol use, poor nutritional status, and low educational status increase the likelihood of developing oral, head and neck carcinoma.

Human papillomavirus (HPV) is another risk factor to consider (see sidebar), although physicians can still reach more people at risk by targeting tobacco and alcohol users, noted Kristen Pytynia, MD, MPH, Assistant Professor of Otolaryngology at the University of Illinois at Chicago.

To reach high-risk populations, otolaryngologists may want to consider taking screening events to homeless shelters, churches in urban or rural settings, and community medical centers that provide care to uninsured populations, said Dr. Gourin.

Every April, OHANCAW provides otolaryngologists with the opportunity to educate and reach out to these communities, said Dr. Johns, adding that free health screenings usually attract local media attention, thereby helping to increase public awareness of the disease and its risk factors. It’s very common for people to be unaware that smoking and drinking raise disease risk, he said.

Additionally, publicizing disease symptoms through media and public education may help people seek out screening if they are experiencing any signs of oral, head and neck cancer, said Dr. Pytynia.

The majority of people with oral, head and neck cancer don’t use the health care system until they have symptoms such as a lump or sore that does not heal, a chronic sore throat, dysphagia, and/or a change or hoarseness in the voice, noted Dr. Gourin.