Recruitment of underserved, high-risk participants to a head and neck cancer screening program

Laryngoscope. 2016 Dec;126(12):2699-2704. doi: 10.1002/lary.26035. Epub 2016 Apr 23.


Objectives/hypothesis: Early detection is essential in head and neck cancer treatment as prognosis varies greatly with stage at diagnosis. Underserved populations often present with advanced disease, and individuals with tobacco and heavy alcohol use demonstrate a higher head and neck cancer incidence. This study aims to evaluate whether various promotional methods differentially recruited behavioral risk factor positive and/or underserved populations to our screening event.

Study design: Prospective cross-sectional study.

Methods: A hospital-based, medical student-run, free head and neck cancer screening event for 187 participants was held in April 2015. Medical campus-based, community-based, and media-based promotions were implemented to recruit participants. Event participants filled out questionnaires to determine how they were recruited, their risk-factor history, and their socioeconomic status. Prevalence of the higher-risk population across the various promotional methods was analyzed.

Results: Community-based promotions were significantly associated with the recruitment of participants in the underserved subgroups, namely uninsured (P = .019), unemployed (P = .006), and those with an annual household income <$20,000 (P < .001). Although not statistically significant, participants with behavioral risk factors reported a higher percentage of recruitment by media-based promotions. Campus-based promotions led to the highest absolute number, but not percentage, of higher-risk participants.

Conclusions: Community-based promotions most efficiently recruit underserved guests to participate in a hospital-based head and neck cancer screening event as compared to media and campus-based promotions. Institutions interested in recruiting higher proportions of underserved guests to these screening events should consider focusing attention and allocation of resources to community-based promotions.

Level of evidence: 4 Laryngoscope, 126:2699-2704, 2016.

Keywords: Head and neck malignancy; cancer prevention; early detection; high-risk behavior.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Community Health Services
  • Cross-Sectional Studies
  • Early Detection of Cancer*
  • Female
  • Florida
  • Head and Neck Neoplasms / diagnosis*
  • Humans
  • Male
  • Middle Aged
  • Patient Selection*
  • Prospective Studies
  • Risk Factors
  • Surveys and Questionnaires
  • Vulnerable Populations