Feasibility study of a head and neck (upper aero-digestive tract) cancer examination

Nearly all of the requirements for a cancer screening program can be met for head and neck--upper aero-digestive tract (UADT)--cancers. These UADT squamous cancers have a clearly definable high-risk group (smokers, greater than or equal to 40 yr), known etiology (tobacco and alcohol), identifiable premalignant lesions, a high prevalence rate worldwide, and high curability with "early" diagnosis. However, a need exists for an efficient detection examination suitable for physicians and dentists alike. Such an examination was designed and field tested as a feasibility study. The examination consisted of a six-step, dentist-oriented, site-targeted, 10-minute procedure, including the use of a fiberoptic pharyngoscope. Two practicing dentists were instructed in the procedure and used it on a randomly selected, high-risk Health America, Inc.--Park DuValle Community Health Center population, who were voluntary responders to a questionnaire and a phone call. Analysis of results showed easy and reproducible teachability, a high degree of acceptance by dentists and examinees, accuracy, and low cost. Associated findings were the following: Of 6,206 respondents, ages 40 and over, 27% were current smokers; 29% were ex-smokers; and 33% never smoked. Of invited current and ex-smokers, ages 40 and over, 51% appeared for a single examination. Compliance emerged as the major problem. The feasibility demonstrated in this study appears to justify a larger, controlled investigation.