Integrating head and neck cancer screening and education with alcohol and tobacco services

Introduction: Prolonged tobacco and alcohol use are the most significant risk factors for the development of cancers of the head and neck including the larynx, esophagus, and oral cavity. In addition, substance use may significantly contribute to co-morbidity among cancer patients receiving treatment. Methods: In depth qualitative interviews were completed with 41 patients newly diagnosed with squamous cell carcinomas of the head and neck. The interviews included questions about past and present health status, health service use including treatment for substance addictions, and treatment decision making. Results: Patients with long term alcohol and tobacco use are infrequently screened for oral cancer by health and addiction service providers despite the presence of significant risk factors and or symptoms. Patients reported very little, if any knowledge or awareness of their risk for head and neck cancer, it's treatment, or outcomes, prior to receiving their diagnosis. Conclusions: Considerable opportunities may exist for integrating addiction and cancer care services for patients at risk for developing cancers of the head and neck. In addition, aspects of 12 step addiction therapy can be useful in developing treatment decision tool-kits that may improve cancer survivorship and co-morbid outcomes.