Barriers to early detection and treatment of head and neck squamous cell carcinoma in African American men.
BACKGROUND
African Amercians afflicted with head and neck squamous cell carcinoma (HNSCC) have a strikingly worse survival than do whites. One apparent cause is an advanced stage of presentation in African Americans. This study was designed to identify barriers to early treatment among African American men.


METHODS
Twenty-four African American male HNSCC survivors completed structured interviews. Interviewers elicited the participants' experiences from symptom recognition to receiving definitive care.


RESULTS
Most participants were seen with advanced-stage HNSCC. Overall, 10% experienced barriers to obtaining early medical care, though 30% were hesitant to seek care due to perceived barriers. Definitive treatment began for 81% within 3 months of initial care seeking.


CONCLUSIONS
Once participants sought care, most of them received definitive treatment within a reasonable time frame. To explain the advanced stage at presentation, either tumor growth rate was extremely rapid or participants sought care when the tumor was quite advanced. The themes suggested by this elicitation study require further validation.
Carroll
William R
WR
Division of Otolaryngology, University of Alabama, Birmingham, Alabama, USA. william.carroll@ccc.uab.edu
Kohler
Connie L
CL
Carter
Vivian L
VL
Hannon
Lonnie
L
Skipper
Joni B
JB
Rosenthal
Eben L
EL
D000328:Adult; D001741:Black or African American; D000368:Aged; D000407:Alabama; D001294:Attitude to Health / Q000208:ethnology; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000208:ethnology* / Q000401:mortality / Q000628:therapy; D055088:Early Detection of Cancer; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000208:ethnology* / Q000401:mortality / Q000628:therapy; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D010865:Pilot Projects; D018570:Risk Assessment; D012959:Socioeconomic Factors; D016019:Survival Analysis; D016896:Treatment Outcome