The Incidence and Survival of HPV-Positive and HPV-Negative Malignant Head and Neck Squamous Cell Carcinoma (HNSCC) in the United States: A Surveillance Epidemiology and End Results SEER 2000-2022 Database Analysis

Author(s)

Dimitrije Grbic, PhD (c), Filip Stanicic, PhD (c), Vlad Zah, DPhil.
ZRx Outcomes Research, Inc., Mississauga, ON, Canada.
OBJECTIVES: Surveillance, Epidemiology, and End Results (SEER, released April 2025) data was used to compare the burden of HPV-positive and HPV-negative head and neck squamous cell carcinoma (HNSCC) in the US.
METHODS: Data from 17 cancer registries (2000-2022) were analyzed with SEER*Stat. The population involved malignant HPV-positive and HPV-negative HNSCC. Outcomes were crude incidence (per 100,000 population) and 4-year survival rates.
RESULTS: 4,220 HPV-positive and 692 HPV-negative HNSCC patients were analyzed. The most common was the oropharynx (99.12% in HPV-positive and 96.5% in HPV-negative). Most HPV-positive patients were 20-64 years old (55.14%), and the HPV-negative patients were 65+ years old (52.31%). HPV-positive and HPV-negative patients were predominantly males (87.54% and 70.09%), non-Hispanic Whites (84.15% and 74.57%), metropolitan county residents (86.73% and 83.09%), and had $65,000-90,000 annual household income (AHI) (41.02% and 41.04%). HPV-positive HNSCC had a higher incidence (0.22 vs. 0.04). Across population subgroups, higher rates of HPV-positive and HPV-negative HNSCC were observed in elderly (0.77 and 0.15), males (0.39 and 0.05), non-Hispanic Whites (0.34 and 0.05), and non-metropolitan residents (0.29 and 0.06). The highest incidence of HPV-positive HNSCC had a $120,000+ AHI category (0.43), while <$40,000 AHI category among HPV-negatives (0.07). Incidence increased between 2018 and 2022 for HPV-positive (0.60 to 2.37) and HPV-negative HNSCC (0.13 to 0.37). HPV-positive HNSCC had higher survival (80.8% vs. 43.4%). HPV-positive and HPV-negative patient rates were lower in older patients, males (80.0% and 42.5%), and non-metropolitan county residents (75.6% and 38.7%). Regarding other subgroups, the lowest survival in HPV-positive cohort had Non-Hispanic American Indians/Alaska Natives (63.3%) and $50,000-55,000 AHI (71.9%). The lowest rates among HPV-negative patients had Hispanics (29.3%) and $95,000-100,000 AHI (28.2%).
CONCLUSIONS: These findings indicate HPV-positive as a more frequent HNSCC type in the US but with a better prognosis. Increasing incidence trends are concerning, indicating the need for novel treatments.

Conference/Value in Health Info

2025-11, ISPOR Europe 2025, Glasgow, Scotland

Value in Health, Volume 28, Issue S2

Code

EPH243

Topic

Epidemiology & Public Health, Real World Data & Information Systems

Disease

Oncology

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