A113

Introduction: Approximately 55, 000 new cases of head and neck cancer will be diagnosed this year, of these new diagnoses 13,000 will die from cancer related issues. Cancer (CA) of the head neck is treatable. The key is early detection. Despite continued improvement in medicine and medical marvels, disparity persists. Early detection occurs in approximately 54% of Caucasians (C) and 48% of African Americans (AA). AAs are diagnosed with some form of CA at a rate of 44 diagnoses per 100,000 individuals more than Cs. The death rate for AAs is 33% higher for all CAs. Early detection helps to treat disease before extensive local destruction and local regional metastasis or distant metastasis can occur. This could change survival rates significantly. Usually head and neck cancers provide symptoms early in disease due to there effect on the airway and the gastro-intestinal system. Despite early symptoms many Americans do not obtain health care. This is due in part to lack of access and lack of knowledge. The “H.E.L.P. (Healthcare Equality in the Life of Every Person) Head and Neck Cancer Screening” aims to conduct cancer screening and education about head neck cancer risk factors to underserved communities. People found to have positive physical findings will be referred to the appropriate health care facility for further care.

Study Objectives

  1. Identify underserved populations with head and neck cancer.

  2. Refer these patients to appropriate health care facilities.

  3. Formulate strategies to reduce the number of untreated or late onset treatment of head and neck cancer in underserved populations.

Patient Selection: Screening was performed at Atlanta homeless shelters.

Methods: Patients were evaluated during screening visits by medical history, demographic questionnaire and a head and neck exam. This includes visualization of the head, neck, oral cavity, oral pharynx and larynx. Larynx and pharynx exam was accomplished using head light and reflective mirror. Also the head and neck were palpated for masses and chest auscultation with a stethoscope. No therapy was given at the screening. Patients were referred to health care facilities based on the findings on physical exam and risk factors.

Conclusion: In our study, the underserved population consisted of homeless and other indigent patients. We found that there was a concerning lack of medical care and although the occurrence of undiagnosed head and neck cancer was not as high as predicted, the occurrence of untreated noncancerous medical issues were substantial. The use of mobile clinics to local homeless shelters and charity food centers offers and effective way to provide health resources to a highly migrant and often noncompliant patient base.

First AACR International Conference on the Science of Cancer Health Disparities-- Nov 27-30, 2007; Atlanta, GA