Human Papillomavirus Genotype and Oropharynx Cancer Survivalin the United States 2

53 Background. The presence of human papillomavirus (HPV) DNA in oropharyngeal 54 squamous cell cancer (OPSCC) tissue appears to be a strong predictor of improved 55 prognosis, but this observation has not been explored in a population-based sample 56 with generalizable findings. 57 Methods . Follow-up data from a large sample of OPSCC patients identified through six 58 population-based cancer registries in the US was used to characterize the association 59 of tumor HPV status with survival. 60 Results. HPV DNA was detected in tumor tissue from 71% (378/529) of the OPSCC 61 patients. A total of 65% of patients with HPV16-associated tumors survived 5-years 62 compared to 46% of patients with other HPV-types and 28% of patients with HPV- 63 negative tumors (p log-rank test <0.0001). The OPSCC patients with detectable HPV16 64 DNA had a 62% reduced hazard of death at 5-years, and patients with other HPV types 65 had a 42% reduced hazard of death at 5-years compared to HPV-negative patients. Compared to non-Hispanic Whites, Blacks with OPSCC had a 2.5-fold greater risk of 67 death at 5-years after adjustment for HPV-status and other prognostic variables. Both surgery and radiation therapy were associated with a reduced 5-year risk of death, but no evidence was an interaction between radiotherapy or surgery on survival time.