Patient perception of risk factors in head and neck cancer

A previous study at our institution noted that only 15% of newly diagnosed patients with oral cancer could identify smoking or alcohol abuse as major risk factors for the development of their cancer. The objective of this study was to determine the effectiveness of a simple educational intervention in 189 consecutively identified patients with head and neck malignancy.

Patients were interviewed prior to and immediately following reading a written educational pamphlet. The patients were then interviewed 5 weeks later to determine longer-term recall. Recall success was correlated to patient demographic parameters including level of education, occupation, sex, age, and place of residence.

Immediate recall success increased, on average, 27% from preintervention knowledge, with the largest increase for the risk factor of alcohol abuse. Five-week postintervention recall success decreased on average 10.5% for all risk factors with the largest decrease being seen for smokeless tobacco use (12%). The immediate and 5-week recall success increases were both statistically significant when compared to the preintervention recall success (p < .05). Patient education level had the greatest impact on recall success at all time points (ANOVA, p < .001). Long-term recall for patients over the age of 60 was also statistically poorer.

An educational intervention can have significant impact on patient knowledge of cancer risk. More effective educational interventions for poorly educated patients and the elderly may have to be devised to increase intervention success. Whether this knowledge translates into behavior change still needs to be studied.