Addressing the health disparities in Head and Neck Cancer among Black Americans: assessing perceptions and awareness of the disease.

Presentation: A016
Topic: Education / Care Delivery
Type: Poster
Authors: Rahilla Tarfa1; Jymirah Morris 1; Vivian Anyaeche1; Uduak-Obong Ekanem2; BaDoi Phan1; Melonie Nance, MD1
Institution(s): 1University of Pittsburgh School of Medicine; 2Tulane University

The disparities in head and neck cancer (HNC) among Black Americans remain stark. Black Americans present with a higher incidence rate and advanced disease at diagnosis. Even as early as within 90 days of treatment, higher rates of mortality are noted among Black Americans after adjusting for age, stage, primary tumor site, HPV status, and treatment type. This points to Black American status as an independent risk factor for HNC mortality, with a multidimensional etiology, rather than a mere reflection of socioeconomic differences. We must elucidate the underlying reasons for this disparity in incidence and outcomes in order to achieve health equity amongst HNC patients.

Awareness and perception of HNC have been studied in different groups globally and appear to be low across populations. However, whether this is a possible contributor to the greater burden of HNC among Black Americans, remains largely unexplored. We hypothesize that gaps in knowledge of HNC and risk perception will become targetable for intervention to combat disparities for HNC in Black Americans. We are currently conducting an online survey of adult Black Americans in the city of Pittsburgh. All participants receive a pre-intervention survey, an intervention (educational video – 13 minutes), and then an immediate post-intervention survey.

We have collected data from 46 respondents, 45 of whom identified as Black/African American (97.83%). 86.05% of our respondents identified as female, and the ages ranged from 21 – 59. 43.9% of our participants had completed a bachelor’s as their highest level of education and 51.22% had full-time employment. The majority of our group had never smoked cigarettes (73.17%), and 56.10% endorsed current alcohol usage. Half of our respondents had never heard of HNC (48.78%), and about the same proportion accurately defined HNC (56.25%). Participants correctly selected 7/30 possible risk factors that can lead to HNC 46.9% of the time, with cigarette smoking and family history with the highest selections. The majority of participants (92.68%) recognized that early diagnosis of HNC improves recovery. Lastly, 58.54% of participants were not aware of any HNC screening programs, and only 43.42% knew an otolaryngologist or ENT would be the physician to treat HNC. After our intervention, 91.89% correctly defined HNC, and participants correctly selected the 7/30 possible risk factors that can lead to HNC 52.34% of the time, with smoking cigarettes, chewing tobacco, and drinking too much alcohol having the highest selections. 91.89% of participants also subsequently correctly identified an otolaryngologist or ENT as the appropriate physician to manage their HNC treatment.

Our investigative survey revealed specific opportunities for patient education on HNC risk and diagnosis among Black Americans in Pittsburgh, a population at-risk for poor HNC outcomes. Our quick inexpensive educational video served as a targeted intervention that closed certain knowledge gaps. We hope that this study will provide a foundation for future interventions to increase awareness of HNC among Black Americans and subsequently all populations at risk of this disease.