University Hospitals Hosts Oral Cancer Screening at Housing Shelter

UH Seidman Cancer Center Update | December 2020

By Nicole M. Fowler, MD, FACS
Associate Program Director, Head & Neck Surgical Oncology and Reconstruction Fellowship
Department of Otolaryngology-Head and Neck Surgery
University Hospitals Cleveland Medical Center
Assistant Professor, Case Western Reserve University School of Medicine

Although Cleveland ranks among the top cities in the country for access to care, barriers still exist. Poverty, lack of medical insurance, and low health literacy lead to delays in care and advanced disease in many head and neck cancer patients. According to US Census data, an estimated 35 percent of the Cleveland population lives in poverty, which equates to approximately 230,000 people and nearly 25,000 people are homeless. Patients with a history of tobacco and alcohol abuse are at higher risk of developing head and neck cancer but may not seek medical evaluation.

 UH Oral Cancer Screening event.

Hoping to target the most vulnerable population in Cleveland, the University Hospitals Community Outreach Coordinator worked with the Community Engagement Supervisor at the YWCA to identify an appropriate location for an oral cancer screening event. This event was held in early October at Cogswell Hall, a temporary housing shelter with 41 residents for those experiencing homelessness. With the help of the American Head and Neck Society (AHNS) community service grant, otolaryngology residents, faculty, nursing and administrative staff from UH Cleveland Medical Center created a mobile clinic space with two exam rooms. Patients were screened upon entry by nursing staff for high-risk behaviors, including tobacco and alcohol abuse, lack of dental care, and/or presence of an oral lesion. A comprehensive history and oral exam was then performed by an otolaryngology resident and faculty.

If, after examination, patients required further evaluation or care, appropriate referrals and information was provided by the administrative team. All individuals were provided with American Head & Neck Cancer information pamphlets as well as bags with oral care supplies provided by the AHNS grant. Twenty individuals were screened at the event with four patients requiring additional follow-up.  One patient was diagnosed with likely head/neck cancer and appropriate follow up arranged for further care.

Special thanks to our two UH residents, Kate Clancy, MD, and Chelsea Hamill, MD, who obtained $1,000 grant funding from the American Head & Neck Society to hold this oral cancer screening event. Efforts will be made to continue to bring this mobile clinic to other locations through the greater Cleveland area.