Disparities in Screening for Head and Neck Cancer: Evidence from the NHANES, 2011‐2014

Objective To measure the association between race and head and neck cancer screening and education. Study Design Nationally representative survey. Setting US National Center for Health Statistics. Subjects and Methods Pooled data from the 2011‐2014 National Health and Nutrition Examination Survey were used to examine disparities in head and neck cancer education and screening among US citizens aged ≥18 years. We measured the association between race and head and neck cancer education and screening, adjusting for age, sex, education, income, and health insurance. Subtype analyses were performed on ever smokers, a lifetime consumption of ≥100 cigarettes, and nonsmokers, a lifetime consumption of <100 cigarettes. Results Among smokers, only 20.2% were educated about the benefits of giving up cigarette smoking; 27.7% had ever received an oral cancer screening examination in which a doctor or dentist pulls on the tongue; and 24.8% had ever had a screening examination in which a doctor or dentist feels the neck. As compared with white smokers, nonwhite smokers were significantly less likely to receive an oral cancer screening examination in which the tongue was pulled (black smokers: odds ratio, 0.44; 95% CI, 0.31‐0.63). Although 72.2% of screenings of white participants were performed by dentists, black participants were more often screened by a physician (36.4%) as compared with any other race. Conclusion This study highlights socioeconomic disparities in head and neck cancer screening and education. We advocate increased patient screening and education by primary care physicians, especially for nonwhite patients and patients with relevant risk factors.