title: A comparison of community-based and hospital-based head and neck cancer screening campaigns: identifying high-risk individuals and early disease.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  METHODS
  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
  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.
authors.affiliation: Department of Otolaryngology–Head and Neck Surgery, Indiana University School of Medicine, 699 West Dr, Riley Research Wing 044, Indianapolis, IN 46202, USA. michharr@iupui.edu
authors.forename: Michael S
authors.initials: MS
authors.lastname: Harris
authors.forename: D Ryan
authors.initials: DR
authors.lastname: Phillips
authors.forename: Julia L
authors.initials: JL
authors.lastname: Sayer
authors.forename: Michael G
authors.initials: MG
authors.lastname: Moore
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003153:Community Health Services / Q000458:organization & administration*; D055088:Early Detection of Cancer; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis*; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D007196:Indiana / Q000453:epidemiology; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D010808:Physical Examination; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D011795:Surveys and Questionnaires; D014030:Tobacco, Smokeless / Q000009:adverse effects