title: Health professionals and the early detection of head and neck cancers: a population-based study in a high incidence area.
abstract: In the context of early detection of head and neck cancers (HNC), the aim of this study was to describe how people sought medical consultation during the year prior to diagnosis and the impact on the stage of the cancer.
  
  
  
  Patients over 20 years old with a diagnosis of HNC in 2010 were included from four French cancer registries. The medical data were matched with data regarding uptake of healthcare issued from French National Health Insurance General Regime.
  
  
  
  In 86.0 % of cases, patients had consulted a general practitioner (GP) and 21.1 % a dentist. Consulting a GP at least once during the year preceding diagnosis was unrelated to Charlson index, age, sex, département, quintile of deprivation of place of residence. Patients from the 'quite privileged', 'quite underprivileged' and 'underprivileged' quintiles consulted a dentist more frequently than those from the 'very underprivileged' quintile (p = 0.007). The stage was less advanced for patients who had consulted a GP (OR = 0.42 [0.18-0.99]) - with a dose-response effect.
  
  
  
  In view of the frequency of consultations, the existence of a significant association between consultations and a localised stage at diagnosis and the absence of a socio-economic association, early detection of HNC by GPs would seem to be the most appropriate way.
authors.affiliation: General Cancer Registry of Lille and its area, GCS-C2RC, F-59037, Lille, France. kligier@registrecancers59.fr.
authors.forename: Karine
authors.initials: K
authors.lastname: Ligier
authors.affiliation: University Hospital of Caen, U1086 INSERM UCBN "Cancers & preventions", F-14000, Caen, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Dejardin
authors.affiliation: University Hospital of Caen, U1086 INSERM UCBN "Cancers & preventions", F-14000, Caen, France.
authors.forename: Ludivine
authors.initials: L
authors.lastname: Launay
authors.affiliation: ERSM-Nord, F-59665, Villeneuve d'Ascq, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Benoit
authors.affiliation: University Hospital of Caen, U1086 INSERM UCBN "Cancers & preventions", F-14000, Caen, France.|Department of Otorhinolaryngology and Cervicofacial Surgery, University Hospital of Caen, F-14000, Caen, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Babin
authors.affiliation: General Cancer Registry of Manche, Centre Hospitalier Public du Cotentin, F-50100, Cherbourg-Octeville, France.
authors.forename: Simona
authors.initials: S
authors.lastname: Bara
authors.affiliation: General Cancer Registry of Somme, Hôpital Nord, F-80054, Amiens, France.
authors.forename: Bénédicte
authors.initials: B
authors.lastname: Lapôtre-Ledoux
authors.affiliation: University Hospital of Caen, U1086 INSERM UCBN "Cancers & preventions", F-14000, Caen, France.|Pôle de Recherche, Centre Hospitalo-Universitaire de Caen, F-14000, Caen, France.
authors.forename: Guy
authors.initials: G
authors.lastname: Launoy
authors.affiliation: General Cancer Registry of Calvados, U1086 INSERM UCBN "Cancers et preventions", Centre F Baclesse, F-14000, Caen, France.
authors.forename: Anne-Valérie
authors.initials: AV
authors.lastname: Guizard
mesh_terms: D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology; D055088:Early Detection of Cancer; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008503:Medical Staff / Q000706:statistics & numerical data*; D008875:Middle Aged; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012307:Risk Factors; D064424:Tobacco Use / Q000453:epidemiology
keywords: Cancers registry; Early detection; Epidemiology; Head and neck cancers; Health insurance; Socio-economic factors; Stage at diagnosis; Uptake of healthcare