title: A survey on pulmonary screening practices among otolaryngology-head & neck surgeons across Canada in the post treatment surveillance of head and neck squamous cell carcinoma.
abstract: BACKGROUND
  Post treatment lung screening for head and neck cancer patients primarily focuses on the distant metastasis and a high rate of second primary can also be expected. The best screening tool and timing for this purpose is controversial. We sought out to assess the current practice and beliefs among Canadian Head and Neck Surgeons.
  
  
  METHODS
  After Ethical Board approval, a nationwide survey was conducted through the Canadian Society of Otolaryngology (CSO) among head and neck surgeons regarding their practices for pulmonary screening in HNSCC patients.
  
  
  RESULTS
  Our CSO survey among Otolaryngology-head and neck surgeons showed that 26 out of 32 respondents perform routine lung screen, out of which 23 (88%) feel that chest radiography should be preferred. The majority of respondents felt that lung screening could impact beneficially on mortality. For symptomatic patients, low-dose spiral CT was the preferred modality (48%), followed by PET/CT scan (14%) and sputum cytology (14%). In high-risk asymptomatic patients (current smoker, radiation exposure, family history and advanced HNSCC), 31% of respondents performed a CXR. The same percentage performed a low dose CT, while 19% relied on PET scan. A further 19% of respondents did not perform any screening in high-risk patients. Most respondents (77%) had more than 10 years practice since graduation from medical school and came from the provinces of Quebec, Ontario and Alberta.
  
  
  CONCLUSIONS
  Chest radiography remains the preferred modality for lung screening and was believed to be impacting beneficially on lung mortality. The recent literature does not seem to be in agreement with those beliefs. Further studies to establish which modality is best and concurrent nation-wide education are warranted.
authors: Department of Otolaryngology-Head and Neck Surgery, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, 3755 Côte Ste-Catherine Road, Montreal, QC, Canada. maddyy@gmail.com.
authors: J
authors: J
authors: Madana
authors: Department of Otolaryngology-Head and Neck Surgery, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, 3755 Côte Ste-Catherine Road, Montreal, QC, Canada. gregoire.morrand@mail.mcgil.ca.
authors: Gregoire B
authors: GB
authors: Morand
authors: Department of Otolaryngology-Head and Neck Surgery, Wayne State University, Detroit, MI, USA. Lleob@wayne.edu.
authors: Luz
authors: L
authors: Barona-Lleo
authors: Department of Otolaryngology-Head and Neck Surgery, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, 3755 Côte Ste-Catherine Road, Montreal, QC, Canada. martin.black@mcgil.ca.
authors: Martin J
authors: MJ
authors: Black
authors: Department of Otolaryngology-Head and Neck Surgery, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, 3755 Côte Ste-Catherine Road, Montreal, QC, Canada. alex.mlynarek@mcgil.ca.
authors: Alex M
authors: AM
authors: Mlynarek
authors: Department of Otolaryngology-Head and Neck Surgery, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, 3755 Côte Ste-Catherine Road, Montreal, QC, Canada. mhier@jgh.mcgil.ca.
authors: Michael P
authors: MP
authors: Hier
mesh_terms: D001291:Attitude of Health Personnel; D002170:Canada; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000556:secondary* / Q000601:surgery; D003952:Diagnostic Imaging / Q000706:statistics & numerical data; D005500:Follow-Up Studies; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000556:secondary*; D008403:Mass Screening / Q000706:statistics & numerical data*; D010036:Otolaryngology; D010039:Otorhinolaryngologic Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D011159:Population Surveillance; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014600:Utilization Review
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