The prevalence of occult carotid artery stenosis in patients with head and neck squamous cell carcinoma.

OBJECTIVES/HYPOTHESIS: Risk factors for atherosclerotic carotid artery disease (ASCAD) and squamous cell carcinoma of the head and neck region (HNSCCA) are similar. This study was conducted to determine whether patients with HNSCCA have an increased rate of occult ASCAD compared with the general population. STUDY DESIGN: A cross-sectional study was performed to identify the prevalence of clinically significant ASCAD in the specific population of patients with a diagnosis of HNSCCA using noninvasive color flow duplex imaging. In addition, the demographic variables and risk factors for head and neck cancer and for carotid disease, as identified in the literature, were recorded with the use of a questionnaire. METHODS: Forty-nine patients with a diagnosis of HNSCCA completed the questionnaire and then had a duplex screening examination. RESULTS: The most common risk factor identified was tobacco smoking in 41 of 49 patients (84%). ASCAD was identified in one patient (2%). The stenosis in that patient was less than 60%. CONCLUSIONS: We conclude from this study that even though patients with HNSCCA usually have risk factor(s) associated with ASCAD, the rate of occult ASCAD was not different from that found in the general population. Thus, routine screening of patients with HNSCCA with color flow duplex imaging to detect occult ASCAD is not warranted.