Husain Solomon, Lohia Shivangi, Petkov Valentina, Blackwell Timothy, Swisher-McClure Samuel, Mizrachi Aviram, Morris Luc G, Cohen Marc A, Wong Richard J, Roman Benjamin R
Department of Head and Neck Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
Penn Medicine Abramson Cancer Center, Philadelphia, Pennsylvania, USA.
Head Neck. 2021 Jul;43(7):2110-2123. doi: 10.1002/hed.26679. Epub 2021 Apr 13.
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.
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.
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).
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.
自2012年以来，美国国立综合癌症网络已推荐对口咽鳞状细胞癌进行人乳头瘤病毒检测。我们研究了数据库登记中该变量存在局限性时，人乳头瘤病毒（HPV）检测报告率的差异及其对这些结果的影响。
在国家癌症数据库（NCDB）和监测、流行病学及最终结果（SEER）中查询2013年至2016年口咽鳞状细胞癌（OPSCC）患者的HPV变量。使用多变量回归基于社会人口统计学变量确定差异。进行敏感性分析以研究该变量的局限性。
尽管数据库中的HPV变量存在局限性，但对推荐检测的依从性仍低于100%，并且在多个社会人口统计学变量上存在显著差异。例如，在NCDB中，70%的白人患者接受了检测，而黑人患者的这一比例为60.4%（优势比[OR]0.75，置信区间[CI]0.66 - 0.85，p≤0.0001）；在SEER中，59.8%的白人患者和47.6%的黑人患者接受了检测（OR 0.73，CI 0.67 - 0.81；p≤0.0001）。
在接受HPV相关OPSCC检测的患者中存在差异，并且对指南推荐的HPV检测的依从性一直不理想。此外，HPV变量的定义，尤其是与p16阳性相关的定义，以及在这两个登记处的使用应加以改进。
