Could adding head and neck cancer screening with lung cancer scans improve survival?

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Head and Neck

Adding head and neck cancer screenings to recommended lung cancer screenings would likely improve early detection and survival, according to a research done by a team led by scientists associated with the University of Pittsburgh Cancer Institute (UPCI). In an article published in the journal Cancer, the team provides the reason for a national clinical trial  – to assess the  benefits of adding examination of the head and neck to lung cancer screening programs. People most at risk for lung cancer are also those most at risk for head and neck cancer.  On the authors found that when head and neck cancer is caught early, the five-year survival rate is over 83%.  Unfortunately, the majority of head and neck cancer cases are diagnosed later when survival rates can shrink below 50%.   Thus, there is  a definite need to develop  ways to identify this type of  cancer when it can still be successfully treated, especially since it is the world’s sixth-most common type of cancer.  Worldwide every year, 600,000 people are diagnosed with it and about 350,000 die. Tobacco use and alcohol consumption are the major risk factors for developing the cancer.   The early symptoms are typically a lump or sore in the mouth or throat, trouble swallowing or a voice change, which are often brushed off as a cold or something that will heal. Treatment, particularly in later stages, can be disfiguring and can change the way a person talks or eats.

The team review medical records of 3,587 people enrolled in the Pittsburgh Lung Screening Study (PLuSS), which consists of current and ex-smokers aged 50 and older, to see if they had a higher chance of developing head and neck cancer.  In the general U.S. population, fewer than 43 per 100,000 people would be expected to develop head and neck cancer yearly among those 50 and older. Among the PLuSS participants, the rate was 71.4 cases annually per 100,000 people.

Recently, several  organizations, recommended annual screening for lung cancer with low-dose computed tomography in people 55 to 74 years old with a smoking history averaging at least a pack a day for a total of 30 years. The recommendation came after a national clinical trial showed that such screening reduces lung cancer mortality.   One of the other team members noted that even though head and neck cancer as relatively rare,   the patients at risk for lung cancer are the same patients that the study shows also likely would benefit from regular head and neck cancer screenings. If such screening reduces mortality in these at-risk patients, that would be a convenient way to increase early detection and save lives.  This multidisciplinary team is collaborating with otolaryngologists to design a national trial that would determine if regular head and neck cancer screenings for people referred for lung cancer screenings would indeed reduce mortality.

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