ArticleJournal of the National Cancer Institute2025
Impact of screening for human papillomavirus-positive oropharyngeal cancers: a microsimulation-based modeling study.
Article in Journal of the National Cancer Institute, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Circulating tumor human papillomavirus DNA whole genome sequencing enables human papillomavirus-associated oropharynx cancer early detection.Journal of the National Cancer Institute · 2026Article
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Authors and funding
10 authors.
Funding
Abstract
backgroundWe estimated the impact of screening on morbidity and mortality of human papillomavirus (HPV)16-positive oropharyngeal cancer among US men aged 45-79 years.
methodsWe developed an individual-level, state-transition natural history microsimulation model to estimate the impact of screening using oral HPV16 detection, HPV16-E6 antibody detection, and transcervical ultrasound of neck/oropharynx. We compared clinical detection to counterfactual screen detection for cancer stage, single- vs multiple-modality treatment, and survival. Screening scenarios encompassed 4 progression speeds across cancer stages (very slow, slow, fast, and very fast) and 4 screening frequencies.
resultsAmong US men aged 45-79 years in 2021 (n = 54 881 311), 163 958 clinically diagnosed human papillomavirus (HPV)-positive oropharyngeal cancers and 32 009 deaths would occur through age 84 in the absence of screening. Assuming very-fast progression, 4%, 20%, 31%, and 60% of these cancers would be detected by one-off, 5-yearly, 3-yearly, and annual screening. Annual screening (very-fast progression) could reduce the number of cancers diagnosed at advanced stages (American Joint Committee on Cancer, 7th edition, stages III/IV: 90.0% with no screening vs 59.1%) and treated by multiple modalities (80.6% with no screening vs 50.6%). Cancer mortality would also be reduced by 36.2%, with a gain of 106 000 life-years. Annual screening would have a number needed to screen (NNS) of 561 per screen-detected cancer, 1118 per additional cancer treated by single modality, 4740 per death prevented, and 520 per life-year gained; such high NNS reflect potential inefficiency of population-level screening.
conclusionsIf proven efficacious in randomized trials and cost-effective, screening for HPV-positive oropharyngeal cancers could provide considerable population-level reductions in advanced stage cancers, treatment-related morbidities, and mortality.
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