Exploring Survival Outcomes in HPV-Mediated (p16+) Oropharyngeal Cancer Among Racial Minority Patients: Insights from SEER Database Analysis

Summary: The landscape of HPV-mediated (p16+) oropharyngeal cancer presents a unique survival profile, yet understanding of survival outcomes in racial minority groups remains limited. As HPV-positive oropharyngeal cancers continue to rise, especially in underserved populations, it becomes crucial to explore how racial disparities impact prognosis. This study leverages the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) database data to probe survival patterns in racial minority patients with HPV-mediated oropharyngeal cancer, aiming to uncover disparities that may influence outcomes in these populations. Using data from 17 SEER registries (2000–2021), we identified 10,296 Non-Hispanic and 942 Hispanic patients (N&#3f11, 238) diagnosed with p16+ oropharyngeal cancer. Inclusion criteria included confirmed p16+ status, documented racial/ethnic demographics, and clinical outcome data. Relative survival analysis comparing specific racial groups with cancer against their healthy cohorts with 95% confidence intervals (CIs) was performed. Chi-square testing was used to assess survival differences between groups. Relative survival rates and CIs by racial groups can be found in Table 1. Of the 11,238 patients with p16+ oropharyngeal cancer identified, 9,330 where Non-Hispanic White and demonstrated the highest relative survival of 94% (95% CI [94, 95]), 91% [90, 92], and 88% [87, 89] at 12, 24, and 36 months, respectively. In contrast, non-Hispanic minority groups displayed lower survival rates, including Black patients (n=603) at 90% (95% CI [87,93]), 84% [80, 87], and 81% [76,85]; American Indian/Alaska Native patients (n=67) at 95% (95% CI [80,98]), 87% [71, 95], and 76% [52, 89]; and Asian or Pacific Islander patients (n=296) at 96% (95% CI [92, 98]), 93% [87, 96], and 87% [79, 93] at 12, 24, and 36 months, respectively. Hispanic patients (n=942) had survival rates of 95% (95% CI [93, 96]), 88% [85, 91], and 85% [81, 89] at 12, 24, and 36 months, respectively. The largest absolute difference in survival was seen between Non-Hispanic White and American Indian/Alaska Native racial group at 36-month timepoint, with a difference of 12% (88% vs. 76%). Chi-square tests revealed statistically significant differences in survival among racial groups across all timepoints, with p-values < 0.001 at 12, 24, and 36 months. This study shows statistically significant differences in survival rates in racial and ethnic minority patients with p16+ oropharyngeal cancer, with Non-Hispanic Black and American Indian/Alaska Native patients having the most unfavorable outcomes. It sets the foundation for further characterization of these differences and their underlying causes. The variability in survival outcomes, particularly broad confidence intervals for smaller minority samples, emphasizes the need for comprehensive investigation into the associated biological, socio-economic, and healthcare access factors, supported by the development of innovative, evidence-based, and culturally sensitive strategies to improve outcomes in these populations. Benjamin C. Kamdem Talom (he/him/his), n/a (Presenting Author) - AUC School of Medicine; Beatriz Finkel-Jimenez, PhD (Co-Author) - AUC School of Medicine; Yasamin Sharifzadeh, MD (Co-Author) - Department of Radiation Oncology, Mayo Clinic