Disparities and guideline adherence for HPV testing among patients with oropharyngeal squamous cell carcinoma, NCDB, and SEER Journal Article


Authors: Husain, S.; Lohia, S.; Petkov, V.; Blackwell, T.; Swisher-McClure, S.; Mizrachi, A.; Morris, L. G.; Cohen, M. A.; Wong, R. J.; Roman, B. R.
Article Title: Disparities and guideline adherence for HPV testing among patients with oropharyngeal squamous cell carcinoma, NCDB, and SEER
Abstract: Background: Human papilloma virus testing for oropharyngeal squamous-cell carcinoma has been recommended by the National Comprehensive Cancer Network since 2012. We examine disparities, reported rates of human papillomavirus (HPV) testing, and the impact on these findings of limitations with the variable in database registries. Methods: The HPV variable was queried for patients with oropharyngeal squamous carcinoma (OPSCC) from 2013 to 2016 in National Cancer Data Base (NCDB) and Surveillance, Epidemiology, and End Results (SEER). Multivariable regression was used to identify disparities based on sociodemographic variables. Sensitivity analyses were used to investigate limitations of the variable. Results: Despite limitations in the HPV variable in the databases, there was less than 100% adherence to recommended testing, and there were significant disparities in multiple sociodemographic variables. For example, in NCDB 70% of white versus 60.4% of black patients were tested (odds ratio [OR] 0.75, confidence interval [CI] 0.66–0.85, p ≤ 0.0001); in SEER 59.8% of white and 47.6% of black patients were tested (OR 0.73, CI 0.67–0.81; p ≤ 0.0001). Conclusions: Disparities exist among patients undergoing testing for HPV-associated OPSCC and adherence to guideline recommended HPV testing has been suboptimal. In addition, the HPV variable definition, especially as it relates to p16 positivity, and use in these two registries should be improved. © 2021 Wiley Periodicals LLC
Keywords: head and neck cancer; testing; oropharynx; hpv; disparities
Journal Title: Head & Neck
Volume: 43
Issue: 7
ISSN: 1043-3074
Publisher: John Wiley & Sons, Inc.  
Date Published: 2021-07-01
Start Page: 2110
End Page: 2123
Language: English
DOI: 10.1002/hed.26679
PUBMED: 33851469
PROVIDER: scopus
PMCID: PMC9405436
DOI/URL:
Notes: Article -- Export Date: 1 July 2021 -- Source: Scopus
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  1. Richard J Wong
    412 Wong
  2. Luc Morris
    278 Morris
  3. Benjamin Raphael Roman
    75 Roman
  4. Marc A Cohen
    130 Cohen
  5. Solomon Husain
    3 Husain
  6. Shivangi Lohia
    15 Lohia