Autoimmune Disease Concomitant with Advanced Head & Neck Squamous Cell Carcinoma

Abstract

Objective: To determine the rate of autoimmune disease in a head and neck cancer patient population and determine if these patients have increased rates of advanced stage disease. Study Design: Retrospective cross-sectional study Setting: Rural tertiary care center Methods: A multisite single institution multidisciplinary head and neck oncologic patient database was queried to identify patients with autoimmune disease and primary mHNSCC in all primary sites from December 2019 to September 2021. Results: A total of 302 patients were identified, with 83% male and 17% female. In this study, 7.3% of patients were found to have an autoimmune disease or on immune-suppressive medications. Of the patients with immune suppression (autoimmune diseases or taking immune-suppressive agents), increased rates of regional and distant metastatic disease were noted. Statistical analysis demonstrated a relative risk of 1.1376 (95% CI 0.8679 – 1.4912) p = 0.3503 for presentation at advanced stage due to nodal disease and a relative risk of 1.4141 (95% CI 0.1876 – 10.6595) p = 0.7367 for presentation at advanced stage due metastatic disease in the autoimmune population. Conclusion: This study suggests that patients with autoimmune diseases and/or on immune-suppressive medications may present with more advanced stages of head and neck squamous cell carcinoma compared to patients without immune suppression. These findings further emphasize the importance of counseling patients on immune-suppressive medications and other risk factors for head and neck squamous cell carcinoma.