Disparities and guideline adherence for HPV testing among patients with oropharyngeal squamous cell carcinoma, NCDB, and SEER

Solomon Husain, Shivangi Lohia*, Valentina Petkov, Timothy Blackwell, Samuel Swisher-McClure, Aviram Mizrachi, Luc G. Morris, Marc A. Cohen, Richard J. Wong, Benjamin R. Roman

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background: Human papilloma virus testing for oropharyngeal squamous-cell carcinoma has been recommended by the National Comprehensive Cancer Network since 2012. We examine disparities, reported rates of human papillomavirus (HPV) testing, and the impact on these findings of limitations with the variable in database registries. Methods: The HPV variable was queried for patients with oropharyngeal squamous carcinoma (OPSCC) from 2013 to 2016 in National Cancer Data Base (NCDB) and Surveillance, Epidemiology, and End Results (SEER). Multivariable regression was used to identify disparities based on sociodemographic variables. Sensitivity analyses were used to investigate limitations of the variable. Results: Despite limitations in the HPV variable in the databases, there was less than 100% adherence to recommended testing, and there were significant disparities in multiple sociodemographic variables. For example, in NCDB 70% of white versus 60.4% of black patients were tested (odds ratio [OR] 0.75, confidence interval [CI] 0.66–0.85, p ≤ 0.0001); in SEER 59.8% of white and 47.6% of black patients were tested (OR 0.73, CI 0.67–0.81; p ≤ 0.0001). Conclusions: Disparities exist among patients undergoing testing for HPV-associated OPSCC and adherence to guideline recommended HPV testing has been suboptimal. In addition, the HPV variable definition, especially as it relates to p16 positivity, and use in these two registries should be improved.

Original languageEnglish
Pages (from-to)2110-2123
Number of pages14
JournalHead and Neck
Issue number7
StatePublished - Jul 2021


  • HPV
  • disparities
  • head and neck cancer
  • oropharynx
  • testing


Dive into the research topics of 'Disparities and guideline adherence for HPV testing among patients with oropharyngeal squamous cell carcinoma, NCDB, and SEER'. Together they form a unique fingerprint.

Cite this