Abstract C88: Awareness of risk factors for head and neck cancer in an at-risk urban population
Authors: Rereddy Shruthi , Moore Charles E. 
Published: May 2015

In 2013, an estimated 53,640 people will be diagnosed with head and neck cancer and approximately 10,520 people will die of this disease. Although this disease affects a relatively small population, it has a significant impact on speech, swallowing, and appearance and is therefore devastating to patients and families. Similar to other malignancies, African Americans and socioeconomically disadvantaged segments of the American population are disproportionately affected by head and neck cancer. From 2003 to 2007, age-adjusted mortality from head and neck cancers in the white population was 3.7 per 100,000 men compared to 6.3 per 100,000 men in the African American population. On average, African American patients develop head and neck cancers at an earlier age, present with more advanced disease, and have a significantly poorer prognosis compared to their white counterparts. A lack of public awareness of head and neck cancer is often cited as contributing to delayed diagnosis and resulting poor prognosis of the disease. We seek to explore whether awareness of risk factors for head and neck cancer varies by race, age, and socioeconomic status and may thus contribute to racial and socioeconomic disparities in disease outcome.

139 subjects residing at a transitional shelter in Atlanta, Georgia were administered a brief survey. This study population was selected to represent a demographic at increased risk of head and neck cancer. The survey questions were written at a school-aged comprehension level. Demographic data collected included age, sex, race, and highest level of educational attainment. Subjects were also asked whether they were aware of tobacco use as risk factor for cancers of the head and neck. As a comparison, they were asked whether they were aware of the association between tobacco use and lung cancer. Descriptive statistics were computed and the associations between demographic variables and cancer awareness responses were analyzed by Fisher's exact and chi-square tests. A subgroup analysis was conducted to evaluate the association between education level and cancer awareness responses in subjects ages &gt;18 years.

Of the 139 subjects, 110 (79.1%) were African American and 29 (20.9) were of another race (white, Hispanic, or Asian). Overall, 89.9% of respondents were aware of the association between tobacco and lung cancer, whereas only 28.1% knew of the association between tobacco and head and neck cancer. Awareness of tobacco as a risk factor for head and neck cancer varied significantly with age: only 15.7% of subjects ages 18 years or younger were aware of the association between tobacco and head and neck cancer, versus 53.3% of those ages 19-35 years and 31.5% of those ages 36 years and over (p=0.01). This age association was not significant for lung cancer awareness (p=0.08). Head and neck cancer awareness also varied significantly with education level in the subgroup analysis of subjects ages &gt;18 years: 0% of subjects with an educational attainment of grade 6 or below was aware of the association between tobacco and head and neck cancer versus 28.6% of those with some high school education and 64.7% of those with some college education or higher (p = 0.015). This association between education level and risk factor awareness was not significant for lung cancer (p=0.43). Risk factor awareness for head and neck cancer did not vary significantly with gender (p=0.83) or race (p=0.06).

Based on this data, it is evident that efforts are needed to increase awareness of head and neck cancer in the American population, particularly youth. To be most effective, an education campaign must be conducted through alternative pathways as the population with the least awareness of this disease is not likely to be reached through traditional school-based campaigns.

Citation Format: Shruthi Rereddy, Charles E. Moore. Awareness of risk factors for head and neck cancer in an at-risk urban population. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr C88. doi:10.1158/1538-7755.DISP13-C88