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The national landscape of human papillomavirus‐associated oropharynx squamous cell carcinoma
Authors:Erik Liederbach  Alexandra Kyrillos  Chi‐Hsiung Wang  Jeffrey C. Liu  Erich M. Sturgis  Mihir K. Bhayani
Affiliation:1. Division of Otolaryngology‐Head and Neck Surgery, Department of Surgery, NorthShore University HealthSystem, Evanston, IL;2. Center for Biomedical Research Informatics, NorthShore University HealthSystem, Evanston, IL;3. Department of Otolaryngology, Temple University School of Medicine, Philadelphia, PA;4. Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, TX;5. Pritzker School of Medicine, University of Chicago, Chicago, IL
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.
Keywords:human papillomavirus  squamous cell carcinoma  oropharynx  National Cancer Data Base  head and neck cancer
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