Cancer Knowledge and Screening among American Indians

Objective: To establish the level of awareness of risk factors and early symptoms of head and neck cancer among American Indians (AI) in South Dakota, and to determine if a community-based head and neck (H&N) cancer screening is an effective method to detect positive findings in this population.

Method: The European Head and Neck Society’s “About Face” survey was augmented with questions on demographics and human papilloma virus (HPV). Surveys were administered at 2 community events, and participants could choose to take part in a H&N cancer screening. Knowledge scores were created for correct responses to H&N cancer questions.

Results: A total of 223 people completed the survey, and 126 participated in the screening: 92% were American Indian, and 32% had pre-existing knowledge of H&N cancer. Mean knowledge scores were 17 (61%) out of 28. Factors that predicted significantly higher H&N cancer knowledge were having or knowing someone with cancer (P = .002), race (P = .02), and education (P = .002). Fifty-nine percent of participants had previous awareness of HPV, but only 36% believed that it was associated with H&N cancer. Ten (8%) people had positive findings on examination. The only significant predictor of a positive finding was smoking history, with all 10 findings being current or past smokers (P = .02).

Conclusion: There are gaps in AI knowledge of H&N cancer risk factors and early symptoms, particularly regarding the role of HPV. These results highlight the need for further public education. Community-based H&N cancer screening in the AI community is an effective means to identify early findings in smokers.