Novel HPV Associated Oropharyngeal Squamous Cell Carcinoma Surveillance DNA Assay Cost Analysis

Objectives We aim to propose a modified surveillance strategy using a novel blood assay that detects plasma circulating tumor‐specific HPV DNA with reported 100% NPV and 94% PPV as the main method of detection to understand the cost implications of potentially avoiding routine imaging and surveillance visits at our institution. Methods We performed a retrospective chart review focusing on recurrences in p16+ patients with OPSCC and defined two surveillance strategies: “Strategy A", follow‐up visits with flexible laryngoscopy (FL) plus regular imaging studies; “Strategy B", follow‐up visits with FL plus regular NavDx assays and imaging used at the discretion of the physician(s) in cases of high clinical suspicion. Results Of the p16+ OPSCC patients (n = 214), 23 had confirmed recurrence (11%). Standard work‐flow model determined 72 imaging studies and 2198 physical examinations with FL were needed to detect one recurrence. Potential individual patient cost reduction during surveillance was 42%. Conclusion Implementing NavDx for HPV + OPSCC surveillance would benefit patients by reducing costs and unnecessary diagnostic testing. Level of Evidence Step/Level 3 Laryngoscope, 133:3006–3012, 2023 We performed a retrospective analysis of patients at our institution with HPV associated squamous cell oropharyngeal carcinoma to determine how to integrate a DNA assay with high positive and negative predictive values called NavDx into a new surveillance strategy. Calculations of health care costs were compared, showing reduced costs using NavDx versus the standard surveillance strategy and other benefits of adopting the new surveillance strategy were also examined.