Methods: Data from the Florida Cancer Data System (1981-2009) was linked with US census to explore survival by demographic characteristics for HPV-associated oropharyngeal cancers including tongue and tonsil cancers. Survival was compared by gender, race, ethnicity, and SES. Multivariable Cox regression models were used to obtain hazard ratio (HR) and 95% confidence interval (95%CI). Overall survival is calculated by the elapsed time from cancer diagnosis to death or last contact for living patients.
Results: From 1981-2009, men had the higher burden of tongue (68.8%) and tonsil (74%) cancers compared to women (31.2% tongue and 26% tonsil). Results from tongue cancer are as follows. Median survival was 1.9yrs (95%CI:1.8-2.0). Blacks had higher mortality than Whites (HR=[1.5]; 95%CI:1.4-1.7). Compared to lowest SES, middle-low ([0.9]; 0.9-0.99), middle-high ([0.9]; 0.8-0.9), and highest ([0.8]; 0.8-0.9) SES had better survival. Current ([1.3]; 1.2-1.4) and former ([1.1]; 1.0-1.2) smokers had higher mortality than never smokers. Results from tonsil cancer are as follows. Median survival was 2.2yrs (2.1-2.3). Blacks had higher mortality than Whites ([1.6]; 1.4-1.7). Hispanics had better survival than non-Hispanics ([0.9]; 0.8-0.96). Compared to lowest SES, middle-low ([0.9]; 0.8-0.98), middle-high ([0.8]; 0.7-0.9), and highest ([0.8]; 0.7-0.9) SES had better survival. Current ([1.5]; 1.3-1.6) and former ([1.2]; 1.1-1.4) smokers had higher mortality than never smokers.
Conclusion: As HPV is the most common sexually transmitted infection in the US and is now one of the most common causes of oropharyngeal cancer, it is vital to understand survival disparities among HPV-associated oropharyngeal cancers. These results may lead to targeted, culturally competent oropharyngeal cancer screening and prevention programs in Florida.
F. Miao, None
T. Koru-Sengul, None