Table 1.
Distribution of baseline patient characteristics by HPV status with associated multivariable odds ratios for odds of HPV-positive HNSCC among U.S. patients age 18 and older with M0 disease (N= 4,735).
| Characteristic a | HPV-Positive HNSCC (N=3,262) | HPV-Negative HNSCC (N=1,473) | Odds of HPV-Positive HNSCC | ||
|---|---|---|---|---|---|
| AOR (95% CI) | P | ||||
| HNSCC Subsite, N (Percent) | |||||
| Non-Oropharynx | 199 (6.1) | 400 (27.2) | 1.0 (Referent) | ||
| Oropharynx | 3063 (93.9) | 1073 (72.8) | 1.90 (1.62–2.24) | <0.001 | |
| Tumor Stage, N (Percent) | |||||
| T1 | 806 (24.7) | 298 (20.2) | 1.0 (Referent) | ||
| T2 | 1183 (36.3) | 397 (27.0) | 1.14 (0.94–1.37) | 0.18 | |
| T3 | 507 (15.5) | 294 (20.0) | 0.80 (0.64–0.99) | 0.04 | |
| T4 | 403 (12.4) | 305 (20.7) | 0.68 (0.54–0.85) | 0.001 | |
| Unknown T | 345 (10.6) | 176 (11.9) | 0.91 (0.69–1.20) | 0.502 | |
| Nodal Stage, N (Percent) | |||||
| N0 | 407 (12.5) | 306 (20.8) | 1.0 (Referent) | ||
| N1 | 595 (18.2) | 300 (20.4) | 1.39 (1.11–1.73) | 0.004 | |
| N2a | 374 (11.5) | 93 (6.3) | 2.16 (1.61–2.88) | <0.001 | |
| N2b | 1139 (34.9) | 369 (25.1) | 1.82 (1.48–2.23) | <0.001 | |
| N2c | 450 (13.8) | 178 (12.1) | 1.70 (1.32–2.18) | <0.001 | |
| N2 NOS | 54 (1.7) | 71 (4.8) | 1.29 (0.83–2.01) | 0.254 | |
| N3 | 163 (5.0) | 82 (5.6) | 1.62 (1.16–2.27) | 0.004 | |
| Unknown N | 80 (2.5) | 74 (5.0) | 2.10 (1.32–3.34) | 0.002 | |
| Initial Definitive Treatment, N (Percent) | |||||
| None | 124 (3.8) | 116 (7.9) | N / A (not patient level characteristic) | ||
| Surgery | 969 (29.7) | 299 (20.3) | |||
| Radiation Therapy | 2959 (90.7) | 1248 (84.7) | |||
| Chemotherapy | 2375 (72.8) | 1009 (68.5) | |||
| Age at Diagnosis, Median (IQR) | N/A | 0.92 (0.98–0.99) | <0.001 | ||
| Race, N (Percent) | |||||
| White | 2774 (85.0) | 990 (67.2) | 1.0 (Referent) | ||
| Non-White | 518 (15.9) | 483 (32.8) | 0.40 (0.31–0.52) | <0.001 | |
| Sex, N (Percent) | |||||
| Female | 428 (13.1) | 338 (22.9) | 1.0 (Referent) | ||
| Male | 2834 (86.9) | 1135 (77.1) | 1.59 (1.33–1.89) | <0.001 | |
| Insurance Status, N (Percent) | |||||
| Private or Other Insurance | 2835 (86.9) | 1091 (74.1) | 1.0 (Referent) | ||
| Uninsured | 79 (2.4) | 70 (4.8) | 0.53 (0.37–0.77) | 0.001 | |
| Medicaid | 302 (9.3) | 286 (19.4) | 0.58 (0.47–0.71) | <0.001 | |
| Unknown | 46 (1.4) | 26 (1.8) | 0.74 (0.43–1.28) | 0.28 | |
| Smoking Propensity,b Median (IQR) | N/A | 1.00 (0.99–1.00) | 0.72 | ||
| Percent High School Education,c Median (IQR) | N/A | 1.02 (1.00–1.03) | 0.01 | ||
| Household Income,c Median (IQR) | N/A | 1.00 (1.00–1.00) | 0.22 | ||
| Marital Status, N (Percent) | |||||
| Married | 2013 | 723 | 1.0 (Referent) | ||
| Single | 532 | 354 | 0.67 (0.56–0.80) | <0.001 | |
| Divorced/Widowed/Separated | 571 | 312 | 0.83 (0.69–0.99) | 0.04 | |
| Unknown | 146 | 84 | 0.78 (0.57–1.07) | 0.13 | |
Abbreviations: AOR, Adjusted Odds Ratio; CI, confidence interval; HNSCC, Head and Neck Squamous Cell Carcinoma; HPV, Human Papillomavirus; N/A, not applicable
Percent may not add up to 100 due to rounding (Percent for Initial Definitive Treatment does not add up to 100 due to receipt of multiple treatments).
Percent ever smoker determined by small area estimates, linked to SEER via estimates developed from the Behavioral Risk Factor Surveillance System (BRFSS) and the National Health Interview Survey (NHIS).
County attribute data, linked to SEER population data by state-county FIPS codes.
When age at diagnosis was treated as a categorical variable (Age 60–64 versus all other ages 15 and older [referent]), age 60–64 was associated with an increased odds of HPV-positive HNSCC (AOR 1.22, 1.02–1.45, P=0.33).