Quick Poll results from the September Issue of OncoFacts 2009
Survival from squamous cell carcinoma of the oropharynx has been shown to be significantly worse in blacks than whites with equivalent stages of presentation. What is the predominant etiology for this difference?
| Lack of access to chemotherapy and radiation therapy |
 |
24.38% |
|
| Differences in oral human papillomavirus (HPV) infection |
|
29.75% |
|
| Insurance status |
|
16.12% |
|
| Differences in epidermal growth factor receptor (EGFR) expression |
|
29.75% |
|
In a recent publication, Settle et al investigated the outcomes of a retrospective cohort of squamous cell carcinoma of the head and neck (SCCHN) treated with chemoradiation and found that the greatest differences in disease-free survival were in those patients with oropharyngeal cancer. Because human papillomavirus (HPV)–positive oropharyngeal cancer patients have significantly better outcomes, the investigators sought to collect data from a different cohort of patients to see if there were racial differences in HPV status. The group analyzed the overall survival (OS) and HPV status of patients in the phase III, multicenter TAX 324 trial of induction chemotherapy followed by concurrent chemoradiation in patients with SCCHN. The difference in survival in those with oropharyngeal cancer was 69.4 months in whites versus 25.2 months in blacks. There was no significant difference in survival by race for the non-oropharyngeal cancer patients. Human papillomavirus positivity was 34% in white versus 4% in black patients. Survival was similar for black and white HPV-negative patients. The authors concluded that the worse OS for black patients with SCCHN was driven by oropharyngeal cancer outcomes, and that for black patients with oropharyngeal cancer by a lower prevalence of HPV infection.
Settle K, Posner MR, Schumaker LM, et al. Racial survival disparity in head and neck cancer results from low prevalence of human papillomavirus infection in black oropharyngeal cancer patients. Cancer Prev Res (Phila Pa). 2009 Jul 29. [Epub ahead of print]. doi: 10.1158/1940-6207.CAPR-09-0149.
* The aggregate results from this question were compiled from the responses submitted by oncologists who participated in the OncoFacts Quick Poll monthly question.