Head and Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Ave., New York, NY 10065, USA.
Oral Oncol. 2013 Dec;49(12):1136-40. doi: 10.1016/j.oraloncology.2013.09.007. Epub 2013 Sep 29.
To describe an institutional experience conducting an annual free head and neck (H&N) cancer screening clinic. Specific aims included: (1) identifying factors predicting which individuals will have findings suspicious for malignancy; and (2) evaluating potential barriers to subsequent follow-up among patients with suspicious findings.
This retrospective cohort study involved individuals presenting to an annual H&N cancer screening clinic (2001-2012). Original screening clinic data and electronic medical records were reviewed. Descriptive and comparative statistics were utilized in order to address the study aims.
Of 1573 participants, 325 (21%) had abnormal findings on screening, of which 183 (12%) had findings suspicious for cancer. No demographic factors predicted a suspicion for cancer. The presence of patient-reported symptoms (16% vs. 8%; p<0.001) were significantly associated with a suspicion for cancer. Only 20% of individuals with a suspicion for cancer returned to our institution for recommended follow-up. Patients who did not complain of symptoms were less likely to return for follow-up (2% vs. 36%; p<0.001). Of the patients who returned for follow-up evaluation, malignancies were diagnosed in three patients.
Few individuals presenting to a H&N cancer screening clinic will have a malignancy detected, and barriers may influence patients' likelihood to present for subsequent evaluation. Due to self-selection among patients presenting for screening, traditional risk factors may not be associated with the likelihood of detecting a suspicion for H&N cancer. Head and neck cancer screening clinics should thus target patients at high risk, and attempt to ensure appropriate follow-up thereafter.
描述进行年度免费头颈部（H&N）癌症筛查诊所的机构经验。具体目标包括：（1）确定哪些因素可预测哪些个体将存在疑似恶性肿瘤的发现；（2）评估具有可疑发现的患者后续随访的潜在障碍。
这项回顾性队列研究涉及参加年度 H&N 癌症筛查诊所（2001-2012 年）的个体。审查了原始筛查诊所数据和电子病历。为了解决研究目标，采用了描述性和比较性统计数据。
在 1573 名参与者中，有 325 名（21%）筛查结果异常，其中 183 名（12%）有疑似癌症的发现。没有人口统计学因素预测癌症的怀疑。患者报告的症状存在（16%比 8%；p<0.001）与癌症的怀疑显著相关。只有 20%的癌症可疑患者返回我们机构进行推荐的随访。没有症状的患者更不可能返回进行随访（2%比 36%；p<0.001）。在返回进行随访评估的患者中，有 3 名患者被诊断出患有恶性肿瘤。
很少有个体在头颈部癌症筛查诊所中发现恶性肿瘤，而障碍可能会影响患者后续评估的可能性。由于筛查中患者的自我选择，传统的危险因素可能与检测头颈部癌症怀疑的可能性无关。头颈部癌症筛查诊所因此应针对高危患者，并尝试确保随后进行适当的随访。
