Cause of Death in Patients with Oropharyngeal Carcinoma by Human Papillomavirus Status: Comparative Data Analysis

Background:The incidence of oropharyngeal squamous cell carcinomas (OPSCC) has increased in recent decades, and human papillomavirus (HPV) infection is the main cause of OPSCC. The data regarding causes of death (CODs) are vitally important in informing follow-up strategies and revising treatment st...

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Bibliographic Details
Published in:JMIR public health and surveillance 2023-08, Vol.9, p.e47579
Main Authors: Zhang, Dong-Dong, Lei, Min, Wang, Yue, Zeng, Pei-Ji, Hong, Yong-Jun, Cai, Cheng-Fu
Format: Article
Language:English
Subjects:
Alcohol use
Chemotherapy
Disease
Epidemiology
Gender
Head & neck cancer
Human papillomavirus
Infections
Medical prognosis
Metastasis
Mortality
Original Paper
Patients
Polymerase chain reaction
Population
Radiation therapy
Statistical analysis
Surgery
Surveillance
Throat cancer
Tobacco
Tumors
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Summary:Background:The incidence of oropharyngeal squamous cell carcinomas (OPSCC) has increased in recent decades, and human papillomavirus (HPV) infection is the main cause of OPSCC. The data regarding causes of death (CODs) are vitally important in informing follow-up strategies and revising treatment strategies to deal with any possible preventable treatment-related COD. However, limited studies have assessed the competing COD by HPV status in patients with OPSCC.Objective:We aimed to analyze the distribution of the competing COD according to HPV status in OPSCC.Methods:We retrospectively included stage I-IVB patients with OPSCC from the Surveillance, Epidemiology, and End Results database between 2010 and 2015. The association between HPV status and head and neck cancer–specific mortality (HNCSM), second primary cancer mortality (SPCM), and noncancer-caused mortality (NCCM) were analyzed. The chi-square test, Kaplan-Meier analysis, and Fine and Gray model were used for statistical analysis.Results:We included 5852 patients in this study and 73.2% (n=4283) of them had HPV-related tumors. A total of 1537 (26.3%) patients died, including 789 (51.3%), 333 (21.7%), and 415 (27%) patients who died from head and neck cancer, second cancer, and noncancer causes, respectively. The 5-year HNCSM, SPCM, NCCM, and overall mortality were 14.7%, 6.5%, 7.7%, and 26.4%, respectively. Those with HPV-positive disease had a lower cumulative incidence of HNCSM (subdistribution hazard ratio [sHR] 0.362, 95% CI 0.315-0.417; P
ISSN:2369-2960
2369-2960
DOI:10.2196/47579