Table 2.

Multivariable aHRs for CSM among U.S. patients ages 25 and older with M0 squamous cell carcinoma of the head and neck, including oropharynx and non-oropharynx (nasopharynx, hypopharynx, or other pharynx) subsites (N = 4,476)

CSM
CharacteristicNo. patients/no. cancer-related deaths/no. competing deathsaHR (95% CI)P
HNSCC subsite × HPV statusa4,476/323/980.37 (0.20–0.68)0.002
HPV status, oropharynx HNSCC3,917/258/83
 HPV-negative1,014/148/341.0 (reference)
 HPV-positive2,903/110/490.40 (0.30–0.53)<0.001
HPV status, non-oropharynx HNSCC559/65/15
 HPV-negative379/46/121.0 (reference)
 HPV-positive180/19/31.08 (0.60–1.93)0.81
Tumor stage
 T11,041/32/111.0 (reference)
 T21,512/60/241.36 (0.88–2.11)0.17
 T3764/71/212.79 (1.78–4.36)<0.001
 T4654/125/304.79 (3.12–7.34)<0.001
 Unknown T505/35/121.83 (1.07–3.13)0.03
Nodal stage
 N0675/54/141.0 (reference)
 N1838/61/111.39 (0.93–2.08)0.11
 N2a444/11/70.85 (0.44–1.65)0.63
 N2b1,439/84/361.42 (0.96–2.11)0.08
 N2c589/64/151.53 (0.97–2.41)0.07
 N2 NOS116/11/41.49 (0.77–2.92)0.24
 N3233/25/52.08 (1.24–3.48)0.006
 Unknown N142/13/60.73 (0.32–1.66)0.45
Initial definitive treatment
 None204/67/101.0 (reference)
 Surgery1,215/35/120.43 (0.29–0.64)<0.001
 Radiation therapy4,001/221/800.23 (0.17–0.31)<0.001
 Chemotherapy3,223/197/620.77 (0.58–1.04)0.09
Age at diagnosis (per year increase)4,476/323/981.04 (1.03–1.05)<0.001
Race
 White3,832/258/741.0 (reference)
 Black342/46/161.05 (0.73–1.50)0.78
 Asian/Pacific Islander241/16/60.90 (0.51–1.60)0.73
 American Indian/Alaskan native40/3/21.14 (0.36–3.61)0.82
 Unknown21/0/0N/A (no events)
Ethnicity
 Non-Spanish/Hispanic/Latino4,170/299/961.0 (reference)
 Spanish/Hispanic/Latino306/24/21.04 (0.67–1.61)0.87
Sex
 Female727/76/131.0 (reference)
 Male3,749/247/850.77 (0.59–1.01)0.06
Insurance status
 Private or other insurance3,727/225/751.0 (reference)
 Uninsured142/19/71.62 (0.96–2.75)0.07
 Medicaid548/67/121.24 (0.91–1.69)0.18
 Unknown insurance59/12/41.74 (0.84–3.63)0.14
Smoking propensity (per 10% increase)b4,476/3231.00 (0.98–1.03)0.79
High school education (per 10% increase)c4,476/3231.02 (0.99–1.05)0.27
Median household income (per 10K increase)c4,476/3230.99 (0.99–1.00)0.22
  • Abbreviations: N/A, not applicable; No, number.

  • aInteraction term: HNSCC subsite (oropharynx vs. non-oropharynx) * HPV status (HPV-positive vs. HPV-negative).

  • bPercent ever-smoker determined by small area estimates, linked to SEER via estimates developed from the BRFSS and the NHIS.

  • cCounty attribute data, linked to SEER population data by state-county FIPS codes.