Altered presentation of oropharyngeal cancer, a 6‐year review

Background Human papilloma virus (HPV)‐associated oropharyngeal squamous cell carcinoma (OPSCC) continues to increase in incidence. Patients are younger, non‐smokers and most commonly present with a neck mass often with no other symptoms. This altered presentation compared with non‐HPV OPSCC may not be recognized by medical practitioners, leading to delayed diagnosis. Methods Patients with histopathological confirmation of OPSCC and known HPV and/or P16 status who presented to our institution between 2012–2017 inclusive were included in the study. Demographic data, tumour characteristics and presenting symptoms were retrospectivxely obtained from both electronic‐ and paper‐based records. Descriptive statistics were used to report demographic data and the two sample t‐test and Fisher's exact test were used to compare groups based on HPV status. Time to diagnosis was also reported. Results A total of 184 patients were included in the study. The majority of patients were male (85.4%) and HPV + (85.3%). The tonsillar complex (53.8%) and tongue base (42.4%) were the most common primary sites. HPV+ patients were less likely to smoke (17.8%) and they commonly presented with a neck mass (39.5% alone or with other symptoms 61.2%). Time to diagnosis in the HPV+ group was longer (15 weeks). Conclusion Our review has highlighted the altered presentation of OPSCC due to the increased incidence of HPV infection. We showed a delayed time to diagnosis in HPV+ OPSCC compared with non‐HPV disease. This confirms the importance of focusing our efforts on educating medical practitioners and creating further awareness to facilitate early detection and treatment. Human papilloma virus (HPV)‐associated oropharyngeal squamous cell carcinoma (OPSCC) continues to increase in incidence. Patients are younger, non‐smokers and most commonly present with a neck mass often with no other symptoms. We showed a delayed time to diagnosis in HPV+ oropharyngeal squamous cell carcinoma compared with non‐HPV disease in our cohort of 184 patients.