Oropharyngeal cancer risk groups in the United States: a meta-analysis and SEER analysis

Incidence of oropharyngeal cancer (OPC) in the United States (US) has increased significantly due to human papillomavirus infections. This study characterized OPC incidence rates (IRs) by subgroups to identify high-risk populations for future screening efforts.

We conducted a comprehensive analysis comprising a systematic review and meta-analysis of studies published since 2000 reporting OPC IRs in the US, supplemented by a primary analysis of data from the Surveillance, Epidemiology, and End Results (SEER) program. From each source, we extracted cases and person-years to calculate IRs per 100,000 person-years (PY). Data from 11 studies selected for meta-analysis were analyzed using random-effects models. We stratified analyses by sex, age, race/ethnicity, and HIV status, as available.

The meta-analysis found an overall OPC IR of 8.2 per 100,000 PY. Men had four times the incidence of OPC than women (13.4 and 3.6 per 100,000 PY, respectively). People living with HIV (PLWH) had the highest IR (27.6 per 100,000 PY), particularly men LWH (35.2 per 100,000 PY, compared to 12.4 in women LWH). SEER data confirmed sex differences, with low incidence in men < 50 years and in women of all ages, and a peak IR among men 60-79 years (32.4 per 100,000 PY). Among men aged 60-79, IRs were higher among White, Black, and American Indian/Alaskan Native (25.7-39.6 per 100,000 PY) than Hispanic/Latino or Asian American/Pacific Islander men (8.8-16.7 per 100,000 PY).

Men aged 50-79 years and PLWH are at highest risk for OPC, with IRs comparable with or exceeding those of other HPV-associated cancers in the US. Any future screening efforts should prioritize these groups while excluding low-risk populations, such as women and individuals < 50 years.

PROSPERO CRD42024588671.