Risk Factors Associated With Metastases in HPV-Related Head/Neck Cancer
Posted: Monday, February 10, 2020
A study published in JCO Oncology Practice identified several demographic and socioeconomic factors associated with metastases at presentation in human papillomavirus (HPV)-related squamous cell carcinoma of the head and neck—including significantly lower odds of metastasis in privately insured patients and higher odds for those living in census tracts with the lowest rates of high school graduates. There has been a sharp increase in the prevalence of HPV in oropharyngeal squamous cell carcinoma in recent decades, reported the authors.
“In the face of a worsening epidemic and the expected continued increase in incidence of this disease and the shift to an older segment of the population, we believe these findings may have significant public health implications,” stated Marta B. Bean, MD, of Emory School of Medicine, Atlanta, and colleagues.
The researchers identified 12,857 patients with HPV-related oropharyngeal carcinomas and 952 patients with HPV-related nonoropharyngeal carcinomas from the National Cancer Database that were diagnosed between 2010 and 2014. The rates of private insurance coverage were 64% and 47%, respectively.
For patients with HPV-related oropharyngeal carcinomas, the odds of metastasis were significantly lower in privately insured patients than in uninsured patients (P < .001), whereas the odds of metastasis were higher for patients living in census tracts with the lowest rates of high school graduates compared with the highest rates (P = .041). Increased odds of metastasis were also associated with a higher tumor stage (P < .001) and nodal stage (P < .001) at the time of diagnosis in patients with HPV-related oropharyngeal carcinomas. However, no demographic or clinical features were associated with metastasis at presentation in patients with HPV-related nonoropharyngeal carcinomas.
Disclosure: The authors’ disclosures can be found at ascopubs.org.