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

Int J Cancer. 2017 Feb 1;140(3):504-512. doi: 10.1002/ijc.30442. Epub 2016 Nov 3.

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: National Cancer Data Base; head and neck cancer; human papillomavirus; oropharynx; squamous cell carcinoma.

MeSH terms

  • Aged
  • Carcinoma, Squamous Cell / epidemiology*
  • Carcinoma, Squamous Cell / virology*
  • Female
  • Head and Neck Neoplasms / epidemiology
  • Humans
  • Male
  • Middle Aged
  • Oropharyngeal Neoplasms / epidemiology*
  • Oropharyngeal Neoplasms / virology*
  • Oropharynx / pathology
  • Oropharynx / virology
  • Papillomaviridae / pathogenicity*
  • Papillomavirus Infections / epidemiology*
  • Papillomavirus Infections / virology
  • Prevalence
  • Racial Groups