Insights into HPV mediated oropharyngeal squamous cell carcinoma: A northern Nevada epidemiological study.

Abstract

e22565 Background: Human papillomavirus (HPV) is a known risk factor for oropharyngeal squamous cell carcinoma (OPSCC), with up to 90% of OPSCC cases being HPV positive. As a result, the HPV surrogate marker p16 has emerged as the most significant independent prognostic marker for outcomes. Despite this, research has yet to analyze the demographics surrounding p16-positive OPSCC within Nevada. This study aimed to investigate differences in p16 positivity and OPSCC presentation, specifically in Northern Nevada. Methods: A retrospective cohort of 295 OPSCC patients diagnosed or treated at Renown Regional Medical Center (RRMC) was identified through Epic from January 2014 to June 2024. Patients without p16 testing were excluded. Demographic and clinical data, including sex, age at diagnosis, smoking pack-years, Nevada mean income quintile, Nevada county, and presenting symptoms (dysphagia and sore throat), were collected. Logistic regression models assessed associations between p16 positivity and selected variables. Results were reported as odds ratios (ORs) with 95% confidence intervals (CIs) and p-values, with statistical significance defined as p < 0.05. Results: Logistic regression evaluated the association between p16 expression and multiple variables. Sex was significantly associated with p16 positivity, with females showing lower odds than males (OR: 0.36, 95% CI: 0.20–0.65, p=0.001). Other variables, including Nevada mean income quintile (OR: 1.13, 95% CI: 0.75–1.72, p=0.562), county (OR: 1.10, 95% CI: 0.62–1.95, p=0.742), dysphagia (OR: 0.76, 95% CI: 0.45–1.27, p=0.297), and sore throat (OR: 1.13, 95% CI: 0.68–1.89, p=0.633), were not significantly associated with p16 expression. Conclusions: Our study demonstrates that sex was significantly associated with p16, with females showing lower odds than males, while other variables, including Nevada mean income quintile, county, dysphagia, and sore throat, were not significantly associated. P16 demographics within Northern Nevada align with previous studies in the U.S. These findings highlight a significant sex-based disparity in p16 expression, emphasizing the need for further investigation into sex-specific molecular pathways and their potential implications for personalized therapeutic strategies, as well as HPV-focused interventions to reduce OPSCC incidence, particularly among older males. The study’s limitations include a lack of data to analyze social determinants of health, such as education, social context, and access to healthcare. Additionally, the data focused on Northern Nevada, excluding the remainder of the Nevadan population. Despite these limitations, this information can help clinicians tailor OPSCC diagnostic, prognostic, and prevention strategies, especially for HPV-driven cancers.