Abstract 1001: Association between oral cancer screening and knowledge of head and neck cancer symptoms and risk factors among Arab Americans
Authors: Al-Antary Nada , Siddiqui Reem , Gilbert Marissa , Fakhoury Lamis , Nair Mrudula , Siddiqui Farzan , Boakye Eric Adjei 
Published: March 2024

Background: Head and neck cancer (HNC) has been increasingly affecting individuals of different ages, significantly contributing to the annual cancer burden in the US. While most HNC cases present at late-stages and are more likely to require aggressive surgical interventions with higher mortality, those who present with premalignant clinical signs or early-stages have a 5-year survival of 70%-90%. Moreover, current HNC public awareness is poor with lack of data on cultural and ethnic minorities. This study evaluated the association between oral cancer screening (OCS) recommendation and receipt and HNC symptoms and risk factors knowledge among Arab Americans in Michigan.

Methods: This was a cross-sectional study of adult Arab Americans conducted between March and July 2023. Surveys were available in English and Arabic per participants preference. Outcome variables were knowledge of three main HNC risk factors—alcohol, cigarette smoking, and HPV— and four of the most common HNC symptoms—nonhealing oral ulcers, dysphagia/odynophagia, voice changes and neck/throat masses—defined as yes/no. OCS was captured as receiving provider-given recommendation for screening and undergoing a screening test (yes/no). Multivariable logistic regression models estimated the associations between OCS and HNC symptoms and risk factor knowledge adjusting for socioeconomic factors.

Results: A total of 295 respondents were included in the study, 9% had received recommendation for OCS and 11% had undergone a screening test. In adjusted models, respondents who did not correctly identify nonhealing oral ulcers (aOR=0.20; 95% CI 0.06-0.67) as HNC symptoms or HPV (aOR=0.15; 95% CI 0.04-0.55) as risk factor of HNC were less likely to have received provider-given recommendation for OCS compared to those who identified the symptom and risk factor. Similarly, respondents who did not correctly identify nonhealing oral ulcers (aOR=0.13; 95% CI 0.04-0.42), dysphagia or odynophagia (aOR=0.22; 95% CI 0.07-0.70), voice changes (aOR=0.27; 95% CI 0.09-0.81), and neck/throat masses (aOR=0.24; 95% CI 0.06-0.91) as HNC symptoms or HPV (aOR=0.07; 95% CI 0.02-0.29) and alcohol (aOR=0.17; 95% CI 0.05-0.58) as HNC risk factors were less likely to have undergone OCS compared to those who identified the symptoms and risk factors.

Conclusion: Respondents who reported limited knowledge of HNC symptoms and risk factors were less likely to be exposed to screening recommendations or testing. Combining screening with education on premalignant and early-stage clinical signs and risk factors might facilitate reduction of HNC incidence and late diagnosis. Further interventions are needed to increase Arab Americans education and identification of high-risk groups by their providers. As HNC screening efficacy remains controversial, future efforts should be directed towards deepening our understanding in this area.

Citation Format: Nada Al-Antary, Reem Siddiqui, Marissa Gilbert, Lamis Fakhoury, Mrudula Nair, Farzan Siddiqui, Eric Adjei Boakye. Association between oral cancer screening and knowledge of head and neck cancer symptoms and risk factors among Arab Americans [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 1001.