When Screening For Lung Cancer, Adding Head And Neck Could Save Lives

By Chuck Seegert, Ph.D.

Patients with risk factors like a history of smoking could benefit from an examination of the head and neck when their lungs are screened for cancer. While it wouldn’t make sense for the general population, patients with risk factors for lung cancer are also the ones most likely to suffer from head and neck cancers.  

Cancer of the head and neck is prominent worldwide. Every year, more than half a million patients are stricken with the disease, and more than half of those succumb to its effects. Major risk factors for the disease include smoking, smokeless tobacco use, and alcohol consumption. The earliest symptoms detected often involve persistent sores in the throat or mouth that can cause trouble swallowing. Some of these lesions may also lead to a voice change, but many of them are ignored because they seem innocuous and are expected to heal.

Early diagnosis of head and neck cancer has been associated with a survival rate as high as 83 percent, according to a recent press release. Unfortunately, when the symptoms appear, it has often progressed past an early stage, which can drop likelihood of survival to as low as 50 percent. In an attempt to combat this disease, researchers at University of Pittsburgh Cancer Institute (UPCI) have performed a preliminary analysis that suggests checking the head and neck when the lungs are screened may help catch many of these cases earlier.

The UPCI research team had previously collected data to study the effectiveness of lung cancer screening in the Pittsburgh Lung Screening Study (PLuSS), according to a recent study published by the team in the journal Cancer. Analysis of head and neck cancer incidence was evaluated retrospectively in across 3,587 participants, with results validating their hypothesis. The general U.S. population will see about 43 cases of head and neck cancer per 100,000 people, but the high-risk group the research team studied showed that there were 71.4 cases per 100,000.

“Head and neck cancer is relatively rare, and screening the general population would be impractical,” said co-author David O. Wilson, M.D., M.P.H., associate director of UPMC’s Lung Cancer Center, in the press release. “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 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.”

History of smoking is a significant risk factor for lung cancer, and several organizations have recommended lung screening, according to the press release. Generally, patients from 55 to 74 years old who have smoked a pack per day for more than 30 years are suggested to be screened annually by low-dose computed tomography (CT). The U.S. preventive services task force and the American Cancer Society are two such organizations that support this approach, which was based on a recent national clinical trial.

The national lung screening trial mentioned in the press release demonstrated that using CT over conventional X-rays led to a 20 percent reduction in lung cancer mortality, according to a recent article on Med Device Online. Additionally, by detecting these cases earlier, the cost savings made the higher cost of the screening method economically sound.