SYMPTOMS IN EARLY HEAD AND NECK-CANCER - AN INADEQUATE INDICATOR

Screening programs show promise in increasing the rate of early detect ion of head and neck cancers in high-risk populations, Prout et al (Ot olaryngol Head Neck Surg 1997;116:201-8) examined the usefulness of a large-scale screening program for head and neck cancer in an inner cit y population by primary care physicians, Symptom assessment was based on the American Cancer Society's ''Seven Warning Signs for Cancer,'' ( Cancer manual. 8th ed. Boston: American Cancer Society, Massachusetts Division; 1990, p. 40-64) 4 of which are relevant to the head and neck , However, these signs may be insufficient for detection of early head and neck cancer. We analyzed these and other typical symptoms to dete rmine their role in early detection. Coincident medical problems, toba cco abuse, and alcohol abuse were also analyzed. Our findings indicate that no symptom or symptom complex is strongly correlated with early head and neck cancer for any subsite except the glottis. Symptom durat ion is an unreliable indicator of the duration of disease. However, pa tients under medical supervision are more likely to have their cancers detected early, supporting the value of surveillance by the primary c are physician. The absence of definite early warning signs for most he ad and neck cancers suggests the need to develop essential screening c riteria. Defining the population that is at high risk for head and nec k cancer and subjecting it to an aggressive screening protocol is esse ntial.