A Faith- and Community-Based Approach to Identifying the Individual at Risk for Head and Neck Cancer in an Inner City

• Published in: The Laryngoscope Vol. 123; no. 6; pp. 1439 - 1443
• Main Authors: Carter, John M., Winters, Ryan D., Lipin, Rosa, Lookabaugh, Sara, Cai, David, Friedlander, Paul L.
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01-06-2013; Wiley Subscription Services, Inc
• Subjects: African American; community; Early Detection of Cancer - methods; faith; Head & neck cancer; Head and neck cancer; Head and Neck Neoplasms - diagnosis; Head and Neck Neoplasms - epidemiology; Head and Neck Neoplasms - psychology; Health care; health disparities; homeless; Homeless people; Homeless Persons; Humans; inner city; Mass Screening; Neck; New Orleans - epidemiology; Prevalence; Prospective Studies; Religion; Risk Assessment - methods; Risk Factors; screening; Shelters; Socioeconomic Factors; Urban Population; New Orleans
• ISSN: 0023-852X; 1531-4995
• DOI: 10.1002/lary.23981

Objectives/Hypothesis
To perform a subset analysis of faith‐ and community‐based screening events to further identify at‐risk populations for head and neck cancer in hopes of further focusing screening efforts.
Study Design
Prospective cohort study.
Methods
Three hundred fifty‐three individuals (n=353) presented to community events and self‐selected for head and neck cancer screenings. A subgroup analysis focusing on risk factors for the development of head and neck cancer and for poor overall prognosis was performed. Subgroups analyzed were individuals screened at church‐affiliated events, social events, or community outreach events at homeless shelters. Statistical analysis was performed using one‐tailed analysis of variance test.
Results
The outreach group had more risk factors for development of cancer, and a significantly higher proportion who used tobacco (P<.05) and consumed >1 drink/day (P<.05). Those in the outreach and church groups had a greater number of risk factors for a poor prognosis with and neck cancer in comparison with the social group: number of uninsured subjects (P<.05), fewer subjects with private insurance (P<.05), fewer subjects with a primary care provider (P<.05), and more subjects with a reported barrier to care (P<.05).
Conclusions
Inhabitants of homeless shelters represent a particularly vulnerable population for both the development and poor prognosis of head and neck cancer. Members of urban church groups are also an at‐risk subpopulation due to the prevalence of poor prognostic risk factors. These groups may benefit from future targeted screenings for head and neck cancer.
Level of Evidence
2 b