Data from Improved Survival with HPV among African Americans with Oropharyngeal Cancer

Abstract

<div>Abstract<p><b>Purpose:</b> A major limitation of studies reporting a lower prevalence rate of human papilloma virus (HPV) in African American patients with oropharyngeal squamous cell cancer (OPSCC) than Caucasian Americans, with corresponding worse outcomes, was adequate representation of HPV-positive African American patients. This study examined survival outcomes in HPV-positive and HPV-negative African Americans with OPSCC.</p><p><b>Experimental Design:</b> The study cohort of 121 patients with primary OPSCC had 42% African Americans. Variables of interest included age, race, gender, HPV status, stage, marital status, smoking, treatment, and date of diagnosis.</p><p><b>Results:</b> Caucasian Americans are more likely to be HPV positive (OR = 3.28; <i>P</i> = 0.035), as are younger age (age < 50 OR = 7.14; <i>P</i> = 0.023 compared with age > 65) or being married (OR = 3.44; <i>P</i> = 0.016). HPV positivity and being unmarried were associated with being late stage (OR = 3.10; <i>P</i> = 0.047 and OR = 3.23; <i>P</i> = 0.038, respectively). HPV-negative patients had 2.7 times the risk of death as HPV-positive patients (<i>P</i> = 0.004). Overall, the HPV-race groups differed (log-rank <i>P</i> < 0.001), with significantly worse survival for HPV-negative African Americans versus (i) HPV-positive African Americans (HR = 3.44; <i>P</i> = 0.0012); (ii) HPV-positive Caucasian Americans (HR = 3.11; <i>P</i> = < 0.049); and (iii) HPV-negative Caucasian Americans (HR = 2.21; <i>P</i> = 0.049).</p><p><b>Conclusions:</b> HPV has a substantial impact on overall survival in African American patients with OPSCC. Among African American patients with OPSCC, HPV-positive patients had better survival than HPV negative. HPV-negative African Americans also did worse than both HPV-positive Caucasian Americans and HPV-negative Caucasian Americans. This study adds to the mounting evidence of HPV as a racially linked sexual behavior life style risk factor impacting survival outcomes for both African American and Caucasian American patients with OPSCC. <i>Clin Cancer Res; 19(9); 2486–92. ©2013 AACR</i>.</p></div>