Mortality Risk in Oropharynx Cancer Varies Based on HPV Status

For patients with oropharynx cancer, the rates of head and neck cancer (HNC) mortality and competing mortality vary depending on human papillomavirus (HPV) status, with increased risks for HNC mortality and competing mortality in HPV-negative patients, according to a study published online January in Cancer.

Zoe H. Fullerton, from Harvard Medical School in Boston, and colleagues examined the causes and risks for short-term mortality among patients with OPC. A Surveillance, Epidemiology, and End Results data set with HPV status was used to identify 4,930 patients with OPC who were diagnosed with nonmetastatic disease from 2013 to 2014. Of these patients, 3,560 (72.2 percent) were HPV-positive and 1,370 were HPV-negative.

The researchers found that HPV-positive patients had a lower risk for two-year cumulative incidence of all-cause mortality compared with HPV-negative patients (10.4 versus 33.3 percent) and a lower risk for HNC-specific mortality (4.8 versus 16.2 percent) and competing-cause mortality (5.6 versus 16.8 percent). Among HPV-negative patients, second-cancer mortality was the most common cause of non-HNC mortality. Compared with patients who had HPV-positive OPC, among patients who had HPV-negative OPC, both second-cancer mortality and noncancer mortality were significantly higher (10.8 and 6.1 versus 2.4 and 3.2 percent, respectively).

"Effective identification of risk factors for competing second-cancer and noncancer mortality can also inform medical management and survivorship screening for patients with OPC," the authors write.

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