Association between human papillomavirus status and health-related quality of life in oropharyngeal and oral cavity cancer survivors

Eva Kjeldsted, Susanne Oksbjerg Dalton, Kirsten Frederiksen, Elo Andersen, Anni Linnet Nielsen, Martin Stafström, Trille Kristina Kjaer

Research output: Contribution to journalArticlepeer-review


Objectives: The human papillomavirus (HPV) is a risk factor for a subgroup of head and neck cancers (HNC). HPV-positive and HPV-negative HNC patients encompass heterogeneous groups regarding risk factors, sociodemographic and clinical characteristics, which may influence health-related quality of life (HRQL) differently. Since this has been sparsely studied, our study investigated the association between HPV status and HRQL in HNC survivors in Denmark. Materials and methods: This cross-sectional study included 179 recurrence-free oropharyngeal and oral cavity squamous cell carcinoma (OSCC) survivors. HRQL was assessed on the EORTC QLQ-C30 and QLQ-H&N35 questionnaires. Linear and logistic regression models were adjusted for sociodemographic, clinical and lifestyle factors. Results: Most unadjusted results showed better HRQL among HPV-positive (n = 119) compared to HPV-negative (n = 60) OSCC survivors (average 18 months since diagnosis). After adjustments, the HPV-positive survivors reported higher role functioning (mean difference [MD] 9.2, 95% confidence interval [CI] 0.1 to –18.4), and fewer problems with speech (MD −9.0, 95% CI −18.0 to −0.1), sexuality (MD −21.9, 95% CI −38.0 to −5.9) and opening mouth (MD −13.7, 95% CI −26.6 to −0.8) compared to HPV-negative survivors. Conclusion: Our findings support that HPV-positive OSCC survivors experience better HRQL than HPV-negative survivors. However, results indicate that sociodemographic, clinical and lifestyle factors explain most of the association between HPV status and HRQL. Findings suggest increased focus on the HPV-negative OSCC survivors with deteriorated HRQL in rehabilitation programs and future research to investigate the long-term effects of treatment among HPV-positive OSCC survivors who may develop symptoms later in survivorship.

Original languageEnglish
Article number104918
JournalOral Oncology
Publication statusPublished - 2020

Subject classification (UKÄ)

  • Cancer and Oncology
  • Public Health, Global Health, Social Medicine and Epidemiology

Free keywords

  • Head and neck cancer
  • HPV
  • Human papillomavirus
  • Late effects
  • Quality of life


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