During The Johns Hopkins Hospital’s first head and neck cancer screening in 2008, Chris Gourin and her colleagues noticed a troubling similarity among the participants asking to be examined: They weren’t the patients who most needed to be there.

The small crowd, made up mostly of young professionals and college graduates, contained only a very few who fit the description of high-risk patients. This year’s screening, held the last week of April, drew a similar group.

Head and neck surgeon Chris Gourin
examines a patient with cancer. A screening,
she says, could have offered prevention.

“They just didn’t fit the typical profile of head and neck cancer patients,” says Gourin, a head and neck surgeon who’s made a medical mission of educating and spreading awareness about the risks of head and neck cancer. Now, hoping to improve their reach for next year’s event, Gourin and her colleagues are searching for the best means of educating not only the medical community, but the patients who may benefit from the free screenings. The challenge, she says, is getting those patients out of their homes and neighborhoods and into the Johns Hopkins Outpatient Center.

Typically, high-risk patients include people who use illicit drugs, alcohol or tobacco, or practice unsafe sex. Socioeconomic factors—such as poverty or a low education level—also predispose people to head and neck cancers, Gourin says, though the reason remains unclear. One hypothesis is that such patients are more likely to contract human papilloma virus (HPV), which can lead to head and neck cancer. 

Screening for head and neck cancer is simple and noninvasive. Physicians take a brief medical history, conduct a physical exam, and ask questions about any possible symptoms, like ear pain, throat pain or trouble swallowing. The process takes only a few minutes but allows enough time for physicians to assess a patient’s risk or detect the possibility of an already-present tumor early, before it has a chance to spread.

Unfortunately, Gourin says, awareness about the risk factors for head and neck cancers remains low, particularly among patients who are most likely to have them. “People don’t think about head and neck cancer when they think about malignant disease,” she says. “They think of the most common cancers like breast, colon or lung cancer, which get a lot of media attention.” In a recent study published this year in the Laryngoscope, Gourin polled a large group of people and found that the majority were unfamiliar with the signs and symptoms of head and neck cancer.

For that reason, the highest-risk patients seem to have remained oblivious to screening initiatives. “We have found that people who do come to a screening were most likely to have learned about the screenings through television or newspaper stories,” rather than hospital publicity efforts, word of mouth or doctor referrals, Gourin says. “If we want to target high-risk patients and educate the larger community, we need to find better ways to get the word out about head and neck cancer.”