Sociodemographic Determinants of Second primary Malignancies in HPV-Mediated Oropharyngeal Cancer: A Population-Based Analysis
1
Oral and Dental Medicine and Surgery, Health Affairs Directorate of El Sharqeya, The Ministry of Health and Population, Zagazig, Egypt
2
Faculty of Medicine, Suez University, Suez, Egypt
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
The rising incidence of Human Papillomavirus (HPV) infection has created a growing cohort of Oropharyngeal Cancer (OPC) survivors. However, the long-term public health burden of Second Malignant Neoplasms (SMN) threatens the sustainability of survivorship models. We analyzed clinical risk factors and treatment delays to identify gaps in care and improve survival outcomes.
METHODS:
This population-based retrospective cohort study utilized cancer registry data (2018–2022) for 20,630 OPC patients. Multivariable logistic regression identified predictors of SMN development, while Cox regression models assessed prognostic factors for survival within the SMN subgroup.
RESULTS:
Second malignancies represented a significant burden, affecting 8.6% (n=1,764) of the cohort. The analysis revealed distinct demographic disparities: susceptibility was primarily driven by age >60 years (OR = 2.68; 95% CI 1.28–6.88; p = 0.019) and HPV-negative status (OR = 1.45; p < 0.001). While nodal burden (N3) significantly correlated with lower SMN incidence (OR = 0.58; p = 0.005), the most critical finding was the impact of systemic delay. Among SMN patients, while HPV positivity offered a survival advantage (HR = 0.68; p = 0.007), delayed treatment initiation (>6 months) emerged as a significant prognostic factor, increasing mortality risk by over two-fold (HR = 2.59; 95% CI 1.52–4.41; p < 0.001). Conversely, surgical intervention was the only modality offering a significant survival benefit (HR = 0.66; p = 0.009).
CONCLUSIONS:
SMNs affect nearly 1 in 11 OPC patients, predominantly impacting older and HPV-negative individuals. The significant mortality risk associated with treatment delays (>6 months) highlights a critical area for intervention. Future strategies should focus on strict monitoring of high-risk groups and reducing time-to-treatment intervals to improve overall survival outcomes.
The rising incidence of Human Papillomavirus (HPV) infection has created a growing cohort of Oropharyngeal Cancer (OPC) survivors. However, the long-term public health burden of Second Malignant Neoplasms (SMN) threatens the sustainability of survivorship models. We analyzed clinical risk factors and treatment delays to identify gaps in care and improve survival outcomes.
METHODS:
This population-based retrospective cohort study utilized cancer registry data (2018–2022) for 20,630 OPC patients. Multivariable logistic regression identified predictors of SMN development, while Cox regression models assessed prognostic factors for survival within the SMN subgroup.
RESULTS:
Second malignancies represented a significant burden, affecting 8.6% (n=1,764) of the cohort. The analysis revealed distinct demographic disparities: susceptibility was primarily driven by age >60 years (OR = 2.68; 95% CI 1.28–6.88; p = 0.019) and HPV-negative status (OR = 1.45; p < 0.001). While nodal burden (N3) significantly correlated with lower SMN incidence (OR = 0.58; p = 0.005), the most critical finding was the impact of systemic delay. Among SMN patients, while HPV positivity offered a survival advantage (HR = 0.68; p = 0.007), delayed treatment initiation (>6 months) emerged as a significant prognostic factor, increasing mortality risk by over two-fold (HR = 2.59; 95% CI 1.52–4.41; p < 0.001). Conversely, surgical intervention was the only modality offering a significant survival benefit (HR = 0.66; p = 0.009).
CONCLUSIONS:
SMNs affect nearly 1 in 11 OPC patients, predominantly impacting older and HPV-negative individuals. The significant mortality risk associated with treatment delays (>6 months) highlights a critical area for intervention. Future strategies should focus on strict monitoring of high-risk groups and reducing time-to-treatment intervals to improve overall survival outcomes.
| eISSN: | 2654-1459 |
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