Temporal and Geographic Trends in HPV Testing for Oropharyngeal Cancer in the United States.

Abstract

Objective: Although human papillomavirus (HPV) testing is fundamental to staging, accurate prognosis, patient management, and clinical trial eligibility in oropharyngeal squamous cell carcinoma (OPSCC), national testing patterns remain unclear. This study investigates temporal and geographic trends in HPV DNA-RNA and/or p16 immunohistochemistry testing for OPSCC in the United States.

Study design: Retrospective cohort study including patients with OPSCC between 2010 and 2021.

Setting: National Cancer Database (NCDB).

Methods: Logistic regression analyses were performed to characterize the association of temporal, demographic, and clinical factors with HPV testing rates.

Results: Among the 146,176 patients with OPSCC and known HPV testing included in the study, the overall HPV testing rate was 88.4% (N = 129,240/146,176). Testing for HPV mediation significantly increased during the study period from 56.0% to 93.6% (adjusted odds ratio [OR]: 1.23, 95% CI: 1.22-1.24, P < .001). Significant differences were measured between geographic regions within the United States (range: 85.6%-91.2%; P < .001). Additionally, demographic, socioeconomic, and hospital-related factors were significantly associated with variations in testing rates.

Conclusion: Despite significant disparities across categories, this study highlights a significant increase in HPV testing rates for OPSCC since 2010, indicating an expanded awareness of its importance in the diagnosis and management of OPSCC. Further research is warranted to address geographic and other disparities to optimize testing for refined patient outcomes.