Source:Cancer Epidemiology, Volume 48
Author(s): Caryn E. Peterson, Shaveta Khosla, Gina D. Jefferson, Faith G. Davis, Marian L. Fitzgibbon, Sally Freels, Timothy P. Johnson, Kent Hoskins, Charlotte E. Joslin
BackgroundNational trends show dramatic increases in the incidence of HPV-related head and neck squamous cell carcinomas (HNSCCs) among black and white males. Using cases identified through the National Cancer Data Base, we assessed factors associated with HPV 16- or 16/18 positive HNSCCs among non-Hispanic black and white males diagnosed in the U.S. between 2009 and 2013.MethodsThis sample included 21,524 HNSCCs with known HPV status. Adjusted relative risks (RRs) and 95% confidence intervals (CIs) were estimated using log-binomial regression.ResultsCompared to those with HPV-negative tumors, male patients diagnosed with HPV-positive HNSCCs were non-Hispanic white, younger at diagnosis, lived in zip-code areas with higher median household income and higher educational attainment, had private health insurance and no reported comorbidities at diagnosis. Although the risk of HPV-positive HNSCCs increased with measures of higher area-level socioeconomic status, the effect was stronger for non-Hispanic black males (RRAdjusted=1.76, 95% CI 1.49–2.09) than for whites (RRAdjusted=1.12, 95% CI 1.08–1.16). The peak age for diagnosis of HPV-positive HNSCCs occurred in those diagnosed at 45–49 years (RRAdjusted=1.57, 95% CI 1.42–1.73). Oropharyngeal tumors were strongly associated with HPV-positivity (RRAdjusted=4.32, 95% CI 4.03–4.63). In the analysis restricted to oropharyngeal anatomic sites, similar patterns persisted.ConclusionIn our analysis, measures of economic advantage were associated with an increased risk of HPV-positive HNSCCs. In order to develop effective interventions, greater understanding of the risk factors for HPV-positive HNSCCs is needed among both high-risk males and their healthcare providers.
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