Original Article |

A Comparison of Community-Based and Hospital-Based Head and Neck Cancer Screening Campaigns:  Identifying High-Risk Individuals and Early Disease

Michael S. Harris, MD; D. Ryan Phillips, MS; Julia L. Sayer, BSN, RN; Michael G. Moore, MD
JAMA Otolaryngol Head Neck Surg. 2013;139(6):568-573. doi:10.1001/jamaoto.2013.3153.
Text Size: A A A
Published online

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.

Figures in this Article

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours


Place holder to copy figure label and caption
Graphic Jump Location

Figure. Screening questionnaire form.




Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics
PubMed Articles