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Cancer detection and survival could be improved by adding head and neck screenings to lung screening


New research carried out at the University of Pittsburgh Cancer Institute (PA, USA) concludes that the addition of head & neck cancer screening to recommended lung cancer screenings could enhance early detection and survival.

The research, which was funded by the National Institutes of Health (MD, USA) and published in the journal Cancer, outlines a rationale for a nationwide clinical trial that will assess the effectiveness of adding head & neck examinations to lung cancer screening programs. The addition is proposed as the individuals at highest risk for lung cancer are also the ones most at risk for head & neck cancer.

“When caught early, the 5 year survival rate for head and neck cancer is over 83%,” commented senior author Brenda Diergaarde (University of Pittsburgh). “However, the majority of cases are diagnosed later when survival rates generally shrink below 50%. There is a strong need to develop strategies that will result in identification of the cancer when it can still be successfully treated.”

As part of the research, Diergaarde’s team analyzed the medical histories of 3587 individuals enrolled in the Pittsburgh Lung Screening Study, which consists of individuals aged 50 years and over who are current or exsmokers. The researchers aimed to discover if these individuals had a greater chance of developing head & neck cancer.

Among the general population of the United States, it would be expected that fewer than 43 individuals per 100,000 over the age of 50 years would develop head & neck cancer in 1 year. Upon analysis of the Pittsburgh Lung Screening Study participants, the rate was 71.4 cases per 100,000 individuals.

Several organizations, including the US Preventive Services Task Force and the American Cancer Society, recently recommended annual lung cancer screening with lowdose computed tomography in individuals aged 55 – 74 years of age. In addition to this age-range stipulation, the individuals would have an average smoking history of at least one packet of cigarettes per day for a total of 30 years. This action was recommended after a national clinical trial demonstrated that the aforementioned screening technique reduces lung cancer mortality.

“Head & neck cancer is relatively rare, and screening the general population would be impractical,” coauthor David O. Wilson (University of Pittsburgh) explained. “However, the patients at risk for lung cancer whom we would refer for the newly recommended annual screening are the same patients that our study shows also likely would benefit from regular head & neck cancer screenings. If such screening reduces mortality in these at-risk patients, it would be a convenient way to increase early detection and save lives.”

Diergaarde’s team is following up this research by collaborating with otolaryngologists to design a national trial, which they hope will discover if head & neck cancer screenings for individuals initially referred for lung cancer screenings would reduce mortality.

Source: University of Pittsburgh Medical Center news release