title: Public awareness of head and neck cancers: a cross-sectional survey.
abstract: OBJECTIVE
  Head and neck cancer (HNC) is responsible for substantial morbidity, mortality, and cost in the United States. Early detection and lifestyle risk factors associated with HNC, both determinants of disease burden and outcomes, are interrelated with public knowledge of this disease. Understanding of current public knowledge of HNC is lacking.
  
  
  OBJECTIVE
  To assess awareness and knowledge of HNC among US adults.
  
  
  METHODS
  Online survey of 2126 randomly selected adults in the United States conducted in 2013.
  
  
  METHODS
  Online survey administration.
  
  
  METHODS
  Subjective and objective assessment of knowledge of HNC including symptoms, risk factors, and association with the human papillomavirus.
  
  
  RESULTS
  Self-reported respondent knowledge of HNC was low, with 66.0% reporting that they were "not very" or "not at all" knowledgeable. This did not vary significantly with tobacco use (P = .92), education (P = .053), sex (P = .07), or race (P = .02). Regarding sites comprising HNC, 22.1% of respondents correctly identified throat cancer, 15.3% mouth cancer, and 2.0% cancer of the larynx, with 21.0% incorrectly identifying brain cancer as HNC. Regarding symptoms, 14.9% of respondents identified "red or white sores that do not heal," 5.2% "sore throat," 1.3% "swelling or lump in the throat," and 0.5% "bleeding in the mouth or throat." Smoking and chewing or spitting tobacco were identified by 54.5% and 32.7% of respondents as risk factors for mouth and throat cancer, respectively. Only 0.8% of respondents identified human papillomavirus (HPV) infection as a risk factor for mouth and throat cancer, but specific questioning revealed that 12.8% were aware of the association between HPV infection and throat cancer whereas 70.0% of respondents were aware of the vaccine targeting HPV.
  
  
  CONCLUSIONS
  Self-reported and objective measures indicate that few American adults know much about HNC including risk factors such as tobacco use and HPV infection and common symptoms. Strategies to improve public awareness and knowledge of signs, symptoms, and risk factors may decrease the disease burden of HNC and are important topics for future research.
authors.affiliation: Department of Surgery, Yale University School of Medicine, New Haven, Connecticut.
authors.forename: Alexander L
authors.initials: AL
authors.lastname: Luryi
authors.affiliation: Department of Surgery, Yale University School of Medicine, New Haven, Connecticut2Yale Cancer Center, Yale University School of Medicine, New Haven, Connecticut.
authors.forename: Wendell G
authors.initials: WG
authors.lastname: Yarbrough
authors.affiliation: Department of Epidemiology, Program of Microbial Diseases, Yale University School of Public Health, New Haven, Connecticut.
authors.forename: Linda M
authors.initials: LM
authors.lastname: Niccolai
authors.affiliation: Department of Surgery, Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Steven
authors.initials: S
authors.lastname: Roser
authors.affiliation: Department of Pediatrics, Medical University of South Carolina College of Medicine, Charleston.
authors.forename: Susan G
authors.initials: SG
authors.lastname: Reed
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Louisiana State University Health Sciences Center, Shreveport.
authors.forename: Cherie-Ann O
authors.initials: CA
authors.lastname: Nathan
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Moore
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina College of Medicine, Charleston.
authors.forename: Terry
authors.initials: T
authors.lastname: Day
authors.affiliation: Department of Surgery, Yale University School of Medicine, New Haven, Connecticut2Yale Cancer Center, Yale University School of Medicine, New Haven, Connecticut.
authors.forename: Benjamin L
authors.initials: BL
authors.lastname: Judson
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006258:Head and Neck Neoplasms / Q000209:etiology; D006801:Humans; D019359:Knowledge; D008297:Male; D030361:Papillomavirus Infections / Q000150:complications; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D014481:United States