A survey on pulmonary screening practices among otolaryngology-head & neck surgeons across Canada in the post treatment surveillance of head and neck squamous cell carcinoma

Abstract

BackgroundPost treatment lung screening for head and neck cancer patients primarily focuses on the distant metastasis and a high rate of second primary can also be expected. The best screening tool and timing for this purpose is controversial. We sought out to assess the current practice and beliefs among Canadian Head and Neck Surgeons.MethodsAfter Ethical Board approval, a nationwide survey was conducted through the Canadian Society of Otolaryngology (CSO) among head and neck surgeons regarding their practices for pulmonary screening in HNSCC patients.ResultsOur CSO survey among Otolaryngology-head and neck surgeons showed that 26 out of 32 respondents perform routine lung screen, out of which 23 (88%) feel that chest radiography should be preferred. The majority of respondents felt that lung screening could impact beneficially on mortality. For symptomatic patients, low-dose spiral CT was the preferred modality (48%), followed by PET/CT scan (14%) and sputum cytology (14%). In high-risk asymptomatic patients (current smoker, radiation exposure, family history and advanced HNSCC), 31% of respondents performed a CXR. The same percentage performed a low dose CT, while 19% relied on PET scan. A further 19% of respondents did not perform any screening in high-risk patients. Most respondents (77%) had more than 10 years practice since graduation from medical school and came from the provinces of Quebec, Ontario and Alberta.ConclusionChest radiography remains the preferred modality for lung screening and was believed to be impacting beneficially on lung mortality. The recent literature does not seem to be in agreement with those beliefs. Further studies to establish which modality is best and concurrent nation-wide education are warranted.

Oral corticosteroid prescribing habits of Canadian Otolaryngologist-Head and Neck Surgeons

“…This study has characterized the corticosteroid prescribing habits of Canadian Otolaryngologist-Head & Neck surgeons for five common conditions in OtoHNS. The 18 % response rate, which is similar to previous survey studies of Canadian Otolaryngologist-Head and Neck surgeons, provides a well-balanced representation of community and academic practice respondents [ 6 – 9 ]. The results demonstrate the significant variability in prescribing habits, as evidenced by the high number of unique dosing regimens for each condition.…”

A Review of Controversial Issues in the Management of Head and Neck Cancer: A Swiss Multidisciplinary and Multi-Institutional Patterns of Care Study—Part 1 (Head and Neck Surgery)

“…Literature on various aspects of management of HNSCC were previously published. Such reports usually focused on an anatomical site of the head and neck area (1, 2), a specific treatment approach in a clinical discipline (3–6), diagnostic modalities and strategies for diagnosis (7) and follow-up (8). Most of these survey-based studies were performed among institutions sharing the same geography or language.…”

Human papillomavirus–associated oropharyngeal squamous cell carcinoma and anogenital cancers in men: Epidemiologic evaluation of association

“…Other oncogenic HPVs are rarely detected in head and neck cancers . Molecular and epidemiologic studies suggest that HPV‐positive OPSCC comprise a distinct disease entity, which has a better prognosis . Immunohistochemistry using p16 has been used as a surrogate marker of oncogenic HPV and is now widely accepted …”

“…6,10 Molecular and epidemiologic studies suggest that HPV-positive OPSCC comprise a distinct disease entity, which has a better prognosis. 3,4,9,[11][12][13][14][15][16][17][18][19][20][21][22][23] Immunohistochemistry using p16 has been used as a surrogate marker of oncogenic HPV and is now widely accepted. 24 Currently, HPV-related cancers are one of the most important topics discussed in oncology, as HPV is a wellestablished etiological factor in carcinomas of the cervix, vulva, anus, and penis.…”