Higher Prevalence of p16-Positive OPSCC Among Males in Northern Nevada: A Regional Epidemiological Study

Background/Objectives: Human papillomavirus (HPV) is a well-established risk factor for oropharyngeal squamous cell carcinoma (OPSCC), with p16 expression serving as a reliable surrogate marker for HPV involvement and an important prognostic indicator. While data exist on the demographic and clinical features of p16-positive OPSCCs on a national scale, limited data exist for Nevada. Methods: This retrospective study evaluated the relationship between p16 positivity and OPSCC presentation in Northern Nevada, with specific attention to associations between p16 status, sex, socioeconomic factors, smoking history, and presenting symptoms. We reviewed medical records of 296 patients diagnosed with OPSCC with concomitant HPV testing at the Renown Regional Medical Center from 2014-2024. Variables of interest included sex, age at diagnosis, smoking pack-years, Nevada census-based income quintile, county of residence, and initial symptoms such as dysphagia and sore throat. Multivariate logistic regression was performed to assess associations between these variables and p16 status. Conclusions: We found that sex was the only variable significantly associated with p16 positivity: females had significantly lower odds of being p16-positive compared to males (OR: 0.36, 95% CI: 0.20-0.65, p = 0.001). This finding of sex-based disparity in HPV-related OPSCC is consistent with national trends. This study is limited by its regional focus and lack of data on other social determinants of health. Nonetheless, the results underscore the importance of gender-informed prevention strategies and highlight the need for further research into the biological and behavioral contributors to this disparity.