Volume 131, Issue 4 pp. 776-781

Original Report

Insurance Status as a Predictor of Treatment in Human Papillomavirus Positive Oropharyngeal Cancer

Michael H. Berger MD,

Michael H. Berger MD

orcid.org/0000-0002-1219-141X

Department of Head and Neck Surgery, University of California Irvine, Irvine, California, U.S.A.

Authors Michael H. Berger and Tyler M. Yasaka contributed equally to the manuscript and are co-first authors.

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Tyler M. Yasaka BS,

Tyler M. Yasaka BS

Department of Head and Neck Surgery, University of California Irvine, Irvine, California, U.S.A.

Authors Michael H. Berger and Tyler M. Yasaka contributed equally to the manuscript and are co-first authors.

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Yarah M. Haidar MD,

Yarah M. Haidar MD

Department of Head and Neck Surgery, University of California Irvine, Irvine, California, U.S.A.

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Edward C. Kuan MD, MBA,

Edward C. Kuan MD, MBA

orcid.org/0000-0003-3475-0718

Department of Head and Neck Surgery, University of California Irvine, Irvine, California, U.S.A.

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Tjoson Tjoa MD,

Corresponding Author

Tjoson Tjoa MD

[email protected]

orcid.org/0000-0001-8777-4145

Department of Head and Neck Surgery, University of California Irvine, Irvine, California, U.S.A.

Send correspondence to Tjoson Tjoa, MD, Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, 200 South Manchester Avenue, Suite 400, Orange, CA 92868. E-mail: [email protected]

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Michael H. Berger MD,

Michael H. Berger MD

orcid.org/0000-0002-1219-141X

Department of Head and Neck Surgery, University of California Irvine, Irvine, California, U.S.A.

Authors Michael H. Berger and Tyler M. Yasaka contributed equally to the manuscript and are co-first authors.

Search for more papers by this author

Tyler M. Yasaka BS,

Tyler M. Yasaka BS

Department of Head and Neck Surgery, University of California Irvine, Irvine, California, U.S.A.

Authors Michael H. Berger and Tyler M. Yasaka contributed equally to the manuscript and are co-first authors.

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Yarah M. Haidar MD,

Yarah M. Haidar MD

Department of Head and Neck Surgery, University of California Irvine, Irvine, California, U.S.A.

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Edward C. Kuan MD, MBA,

Edward C. Kuan MD, MBA

orcid.org/0000-0003-3475-0718

Department of Head and Neck Surgery, University of California Irvine, Irvine, California, U.S.A.

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Tjoson Tjoa MD,

Corresponding Author

Tjoson Tjoa MD

[email protected]

orcid.org/0000-0001-8777-4145

Department of Head and Neck Surgery, University of California Irvine, Irvine, California, U.S.A.

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First published: 13 August 2020

https://doi.org/10.1002/lary.28984

Citations: 11

Editor's Note: This Manuscript was accepted for publication on July 10, 2020.

The authors have no funding or conflicts of interest to declare.

Research included in this manuscript was presented at the Triological Society Combined Sections Meeting in San Diego, CA on January 23–25, 2020.

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Abstract

Objectives

The link between human papillomavirus (HPV) and oropharyngeal cancer (OPC) is well known. Locally advanced, HPV-positive OPC (HPV OPC) can be treated with either chemoradiation or primary surgery with or without adjuvant therapy. Head and neck cancer patients with government insurance or uninsured have been shown to have worse prognosis than similar patients with private insurance. In this study, we aimed to determine if insurance status would predict treatment modality in patients with HPV OPC.

Study Design

A retrospective analysis using the National Cancer Database (NCDB).

Methods

The National Cancer Database was used to identify patients with HPV OPC who underwent primary surgery or primary chemoradiation from 2010–2015. Insurance status was categorized as government, private, or no insurance. The relationship between insurance status and treatment was investigated using Chi square and multivariate regression models. Kaplan–Meier analyses were performed comparing overall survival (OS) by insurance status.

Results

There were 10,606 patients were included. There was a statistically significant correlation between insurance status and primary treatment modality for HPV OPC (P < .001). Patients with government insurance were 19.3% less likely to undergo surgery and uninsured patients were 36.9% less likely to undergo primary surgery when compared to those with private insurance (P < .001), even after correcting for TNM stage in multivariate analysis. There was an improved 5-year OS for patients with private insurance (86.6%) versus both government insurance (68.4%) and no insurance (69.9%) (P < .001).

Conclusions

Patients with private insurance are more likely to undergo primary surgery in HPV OPC and have improved overall survival.

Level of Evidence

4 Laryngoscope, 131:776–781, 2021

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Citing Literature

Volume131, Issue4

April 2021

Pages 776-781

Insurance Status as a Predictor of Treatment in Human Papillomavirus Positive Oropharyngeal Cancer

Abstract

Objectives

Study Design

Methods

Results

Conclusions

Level of Evidence

BIBLIOGRAPHY

Citing Literature

References

Information

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Insurance Status as a Predictor of Treatment in Human Papillomavirus Positive Oropharyngeal Cancer

Abstract

Objectives

Study Design

Methods

Results

Conclusions

Level of Evidence

BIBLIOGRAPHY

Citing Literature

References

Related

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