TY - JOUR
T1 - Association between human papillomavirus status and health-related quality of life in oropharyngeal and oral cavity cancer survivors
AU - Kjeldsted, Eva
AU - Dalton, Susanne Oksbjerg
AU - Frederiksen, Kirsten
AU - Andersen, Elo
AU - Nielsen, Anni Linnet
AU - Stafstrom, Martin
AU - Kjaer, Trille Kristina
PY - 2020
Y1 - 2020
N2 - Objectives: The human papillomavirus (HPV) is a risk factor for a subgroup of head and neck cancers (HNC). HPV-positive and HPV-negative HNC patients encompass heterogeneous groups regarding risk factors, sociodemographic and clinical characteristics, which may influence health-related quality of life (HRQL) differently. Since this has been sparsely studied, our study investigated the association between HPV status and HRQL in HNC survivors in Denmark.Materials and methods: This cross-sectional study included 179 recurrence-free oropharyngeal and oral cavity squamous cell carcinoma (OSCC) survivors. HRQL was assessed on the EORTC QLQ-C30 and QLQ-H&N35 questionnaires. Linear and logistic regression models were adjusted for sociodemographic, clinical and lifestyle factors.Results: Most unadjusted results showed better HRQL among HPV-positive (n = 119) compared to HPV-negative (n = 60) OSCC survivors (average 18 months since diagnosis). After adjustments, the HPV-positive survivors reported higher role functioning (mean difference [MD] 9.2, 95% confidence interval [CI] 0.1 to -18.4), and fewer problems with speech (MD - 9.0, 95% CI -18.0 to - 0.1), sexuality (MD - 21.9, 95% CI - 38.0 to - 5.9) and opening mouth (MD - 13.7, 95% CI - 26.6 to - 0.8) compared to HPV-negative survivors.Conclusion: Our findings support that HPV-positive OSCC survivors experience better HRQL than HPV-negative survivors. However, results indicate that sociodemographic, clinical and lifestyle factors explain most of the association between HPV status and HRQL. Findings suggest increased focus on the HPV-negative OSCC survivors with deteriorated HRQL in rehabilitation programs and future research to investigate the long-term effects of treatment among HPV-positive OSCC survivors who may develop symptoms later in survivorship.
AB - Objectives: The human papillomavirus (HPV) is a risk factor for a subgroup of head and neck cancers (HNC). HPV-positive and HPV-negative HNC patients encompass heterogeneous groups regarding risk factors, sociodemographic and clinical characteristics, which may influence health-related quality of life (HRQL) differently. Since this has been sparsely studied, our study investigated the association between HPV status and HRQL in HNC survivors in Denmark.Materials and methods: This cross-sectional study included 179 recurrence-free oropharyngeal and oral cavity squamous cell carcinoma (OSCC) survivors. HRQL was assessed on the EORTC QLQ-C30 and QLQ-H&N35 questionnaires. Linear and logistic regression models were adjusted for sociodemographic, clinical and lifestyle factors.Results: Most unadjusted results showed better HRQL among HPV-positive (n = 119) compared to HPV-negative (n = 60) OSCC survivors (average 18 months since diagnosis). After adjustments, the HPV-positive survivors reported higher role functioning (mean difference [MD] 9.2, 95% confidence interval [CI] 0.1 to -18.4), and fewer problems with speech (MD - 9.0, 95% CI -18.0 to - 0.1), sexuality (MD - 21.9, 95% CI - 38.0 to - 5.9) and opening mouth (MD - 13.7, 95% CI - 26.6 to - 0.8) compared to HPV-negative survivors.Conclusion: Our findings support that HPV-positive OSCC survivors experience better HRQL than HPV-negative survivors. However, results indicate that sociodemographic, clinical and lifestyle factors explain most of the association between HPV status and HRQL. Findings suggest increased focus on the HPV-negative OSCC survivors with deteriorated HRQL in rehabilitation programs and future research to investigate the long-term effects of treatment among HPV-positive OSCC survivors who may develop symptoms later in survivorship.
KW - HPV
KW - Human papillomavirus
KW - Head and neck cancer
KW - Quality of life
KW - Late effects
KW - SQUAMOUS-CELL CARCINOMA
KW - NECK
KW - HEAD
KW - RISK
U2 - 10.1016/j.oraloncology.2020.104918
DO - 10.1016/j.oraloncology.2020.104918
M3 - Journal article
C2 - 32795908
VL - 109
JO - Oral Oncology Extra
JF - Oral Oncology Extra
SN - 1741-9409
M1 - 104918
ER -