The national landscape of human papillomavirus-associated oropharynx squamous cell carcinoma

Abstract

The head and neck squamous cell carcinoma (HNC) landscape is evolving with human papillomavirus (HPV) being a rising cause of oropharynx carcinoma (OPC). This study seeks to investigate a national database for HPV-associated oropharynx carcinoma (HPV-OPC). Using the National Cancer Data Base, we analyzed 22,693 patients with HPV-OPC and known HPV status. Chi-square tests and logistic regression models were utilized to examine differences between HPV positive and HPV negative OPC. 14,805 (65.2%) patients were HPV positive. Mean age at presentation was 58.4 years with HPV-HNC patients being 2.8 years younger compared to the HPV-negative cohort (58.4 vs. 61.2 years, p < 0.001). 67.6% of white patients were HPV-positive compared to 42.3% of African American patients and 57.1% of Hispanics (p < 0.001). When combining race and socioeconomic status (SES), we found African American patients in high SES groups had HPV-OPC prevalence that was significantly higher than African American patients in low SES groups (56.9% vs. 36.3%, p < 0.001). Geographic distribution of HPV-OPC was also analyzed and found to be most prevalent in Western states and least prevalent in the Southern states (p < 0.001). The distribution of HPV-OPC is variable across the country and among racial and socioeconomic groups. A broad understanding of these differences in HPV-OPC should drive educational programs and improve clinical trials that benefit both prevention and current treatments.

Racial disparities in tumor features and outcomes of patients with squamous cell carcinoma of the tonsil

“…demonstrated in a cohort of 121 patients worse survival for HPV‐negative black patients compared to HPV‐negative white patients (HR 2.21, P = 0.049) . HPV‐associated tumors are more common in white patients; accordingly, survival disparities between races in OPC are postulated to be due to the differences in biologic drivers of the disease . However, among patients with HPV‐negative disease, black patients may still have decreased survival highlighting other potential causes of racial disparities in high‐risk OPC.…”

“…Approximately 60% to 70% of newly diagnosed cases of oropharyngeal cancer are related to human papillomavirus (HPV) infection and have superior outcomes as compared to HPV‐negative oropharyngeal cancers . However, because black patients are less likely to have HPV‐associated oropharyngeal cancer, worse survival among black patients with OPC is often attributed to the lower incidence of HPV‐driven disease in this population …”

“…[14][15][16][17] However, because black patients are less likely to have HPV-associated oropharyngeal cancer, worse survival among black patients with OPC is often attributed to the lower incidence of HPV-driven disease in this population. [18][19][20][21][22] Less data are available about the individual subsites of the oropharynx with regard to survival outcomes based on race. Subsites of the oropharynx include base of tongue, soft palate, tonsils, and posterior pharyngeal wall.…”

Prevalence and Prognostic Significance of HPV in Laryngeal Squamous Cell Carcinoma in Northeast China

“…However, only a few studies have examined HPV-associated HNSCC in China [15]. Numerous studies have focused on HPV and p16 in OPSCC, while very few studies have addressed LSCC [16][17][18].…”

Primary surgery versus primary radiation‐based treatment for locally advanced oropharyngeal cancer

“…One strength of our study is the large number of patients, enabling analyses by stage and multiple patient factors, including data on socioeconomic factors that may impact outcome. 11,36,38,40 Despite the limitations of the current study, this data addresses survival differences between primary surgery versus primary radiation approaches for OPC and thus is important given the current lack of robust randomized data comparing these treatment modalities. However, in the management of OPC, survival should not be the only endpoint in evaluating treatment decisions.…”