HEAD AND NECK-CANCER SCREENING AMONG 4611 TOBACCO USERS OLDER THAN 40YEARS

We implemented screening for squamous cell carcinomas of the oral cavi ty, pharynx, and larynx with symptom assessment and systematic inspect ion of the oral mucosa by primary care practitioners at health care si tes serving inner-city residents of Boston; 4611 tobacco users older t han 40 years were screened, and 313 with specific criteria were referr ed to otolaryngology for diagnostic evaluations. In these screened pat ients, the prevalence of oral mucosal lesions was almost 13% and preva lence of persistent hoarseness was more than 11%. Although the identif ication of these cancers was rare (nearly 3%), abnormal findings were seen in more than 70% of referred patients. These clinical and histolo gic diagnoses are described. We have documented the range of pathologi c conditions in high-risk patients screened for upper aerodigestive tr act malignancy.