Disability-adjusted life-years from human papillomavirus-related oral cavity and pharynx cancers in US men, 2017-2021

Squamous cell oropharyngeal cancer (OPC) incidence in men has surpassed cervical cancer in women as the most common cancer linked to high-risk human papillomavirus (HPV). However, vaccine uptake remains suboptimal in both sexes. The objectives of this study were to quantify disability-adjusted life-years (DALYs) because of HPV-associated OPC in US men from 2017 to 2021 and to highlight the potential impact of widespread vaccination.

Crude incidence counts and 12-month survival rates were extracted from the National Cancer Institute's Surveillance, Epidemiology, and End Results SEER 17 database for OPC of the tonsils and tongue base. HPV-attributable cases were estimated by using population-attributable fractions. DALYs were calculated as the sum of years of life lost, years lived with disability among survivors, and years lived with disability among decedents. The annual percent change was used to assess trends.

From 2017 to 2021 in US men, average annual DALYs were highest for tonsillar cancers (n = 58,979), followed by base of tongue cancers (n = 40,440). DALYs decreased significantly for cancers of the tonsils (annual percent change, -2.44%) and the base of tongue (annual percent change, -4.28%). Among adults aged 65 years and older, DALYs increased for both subsites.

Tonsillar cancers carried the highest DALY burden among HPV-associated OPCs in US men. Patients who were aged 65 years and older and were never vaccine-eligible presented significant DALY increases across all cancer subsites, emphasizing the need for gender-neutral HPV vaccination and catch-up programs for high-risk older men.