Head and Neck Cancer Screening in Homeless Communities: HEAL (Health Education, Assessment, and Leadership)

摘要

Homeless persons are at high risk for medical illness, particularly for head and neck cancers, but they face several barriers to receiving adequate health care. We conducted cancer screening and education about head and neck cancer risk factors in one such population (n = 325). Although 41.4% of the participants reported at least 1 otolaryngologic sign or symptom, and 8.6% reported having 2 or more symptoms, most of them (72.3%) had received no medical care. The symptom reported most often was a change in voice (17.2%). In all, 11% of the participants were referred for head or neck cancer evaluation, and 9% of those undergoing biopsy had a malignancy that was later treated. Nearly 75% of participants had at least a ninth-grade education. However, although 71.2% knew that the use of tobacco can lead to lung cancer, 78.9% did not recognize that it can also lead to head or neck cancer. In this population, cigarette smoking was associated with more than doubled odds of follow-up medical care (odds ratio, 2.31). Head and neck cancers cause substantial morbidity and mortality. Community outreach programs can be an excellent starting point to improving early detection and health education for underserved communities.