Patients with HPV-negative oropharynx cancer have higher risk of early death

New research indicates that there is a higher risk of early death among patients with oropharynx cancer when not caused by human papillomavirus (HPV), than those whose tumors are HPV-positive.

The findings are published early online in CANCER, a peer-reviewed journal of the American Cancer Society.

The incidence of oropharynx cancer--a type of throat cancer that occurs in the tonsils and base of the tongue--is increasing in the United States, with rates that are more than twice as high in men than in women.

Recent evidence has shown that approximately 75 percent of these cancers are due to infection with HPV, a sexually transmitted virus that can mostly be prevented through vaccination.

A team led by Danielle N. Margalit, MD, MPH, of the Dana-Farber/Brigham & Women's Cancer Center and Harvard Medical School in Boston, designed a study to better understand the causes and risks of early death among patients with oropharynx cancer and to determine how these risks differ in patients with and without HPV-related tumors.

The researchers' analysis included information on 4,930 U.S. patients who were diagnosed with nonmetastatic oropharynx cancer from 2013 to 2014, including 3,560 whose cancers were HPV-positive and 1,370 whose cancers were HPV-negative. Patients were followed for a median of 11 months.

Compared with patients whose cancers were HPV-negative, those whose cancers were HPV-positive had a lower risk of dying from any cause within two years (10.4 percent versus 33.3 percent) and a lower risk of dying from head and neck cancer (4.8 percent versus 16.2 percent).

Patients who had HPV-positive oropharynx cancer also had a lower risk of dying from cancers other than head and neck cancer.

The study is really eye-opening when it comes to the high risk of death among patients with HPV-negative oropharynx cancer. The information can be put to use by clinicians who see patients after treatment.

They need to be vigilant not just about head and neck cancer recurrence, but also about screening for other cancers and non-cancer comorbidities that can influence patients' risk of early death, and they should counsel patients on addressing modifiable risk factors."

Dr. Danielle N. Margalit, MD, MPH, Dana-Farber/Brigham & Women's Cancer Center

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