Abstract 4255: Differences in the sociodemographic correlates of HPV-associated cancer survival in the United States
Authors: Osazuwa-Peters Nosayaba , Simpson Matthew C. , Boakye Eric Adjei , Mohammed Kahee A. , Zhao Longwen , Challapalli Sai D. , Rohde Rebecca L. , Pham Vy T. , Massa Sean T. , Varvares Mark A. 
Published: August 2018

Purpose: Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States. One in every four individuals-nearly 80 million-is infected. More than 38,000 new cases of HPV-associated cancers are diagnosed annually. However, factors related to HPV-associated cancer survivorship, based on primary anatomic site, remain understudied. The aim of this study was to assess sociodemographic factors related to survival following diagnosis of HPV-associated cancers in the United States.

Methods: Patients ≥18 years diagnosed with first-primary HPV-associated cancer between 2007 and 2014 were identified from the Surveillance, Epidemiology, and End Results 18. HPV-associated cancers sites were defined as anal, cervical, oropharyngeal, penile, vaginal, and vulvar per the International Classification of Diseases for Oncology, third edition codes. Kaplan-Meier curves showing cancer-specific survival (CSS) from each HPV-associated cancer site stratified by sex with differences assessed by log-rank tests. Fine and Gray proportional hazards regression models for each HPV-associated site controlled for clinical covariates and estimated sociodemographic predictors of hazard of death from cancer.

Results: A total of 63,329 patients with HPV-associated cancers were included in the analyses. The most common sites were cervix for females (58%) and oropharynx for males (78%). Overall 8-year survival at the end of follow-up was 56%. For males, anal cancer had the lowest CSS (62%) compared to oropharyngeal (69%) and penile (72%) cancer (p&lt;0.01). For females, vaginal cancer had the lowest CSS (46%) compared to anal (71%), cervical (67%), oropharyngeal (57%), and vulvar (72%) cancer. Final adjusted model showed significant CSS differences based on sociodemographic factors, including sex, age, marital status, race/ethnicity, and insurance status. Males were more likely to die from anal cancer compared to females (aHR=1.53, 95% CI 1.39, 1.68), while less likely than females to die from oropharyngeal cancer (aHR=0.91, 95% CI 0.84, 0.98). Blacks were more likely to die from anal (aHR=1.33, 95% CI 1.16, 1.52), cervical (aHR=1.13, 95% CI 1.05, 1.22), and oropharyngeal cancer (aHR=1.54, 95% CI 1.41, 1.68) compared with Whites. Each increasing year of diagnosis was associated with a 1-3% increase in hazard of cancer-specific death for all cancers.

Conclusions: There is marked variability in sociodemographic correlates among HPV-associated cancer survivors in the United States, based on sex, age, insurance and marital status, race/ethnicity, and cancer type. This has important implications for clinical decision making and identification of populations at greater risk of death from HPV-associated cancers.

Citation Format: Nosayaba Osazuwa-Peters, Matthew C. Simpson, Eric Adjei Boakye, Kahee A. Mohammed, Longwen Zhao, Sai D. Challapalli, Rebecca L. Rohde, Vy T. Pham, Sean T. Massa, Mark A. Varvares. Differences in the sociodemographic correlates of HPV-associated cancer survival in the United States [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 4255.