title: Socioeconomic characteristics of patients with oropharyngeal carcinoma according to tumor HPV status, patient smoking status, and sexual behavior.
abstract: OBJECTIVE
  Patients with oropharyngeal cancer (OPC) have distinct risk factor profiles reflected in the human papillomavirus (HPV) status of their tumor, and these profiles may also be influenced by factors related to socioeconomic status (SES). The goal of this study was to describe the socioeconomic characteristics of a large cohort of patients with OPC according to HPV status, smoking status, and sexual behavior.
  
  
  METHODS
  Patients with OPC prospectively provided information about their smoking and alcohol use, socioeconomic characteristics, and sexual behaviors. HPV status was determined by a composite of immunohistochemistry for p16 expression, HPV in situ hybridization, and PCR assay in 356 patients. Standard descriptive statistics and logistic regression were used to compare socioeconomic characteristics between patient subgroups.
  
  
  RESULTS
  Patients with HPV-positive OPC had higher levels of education, income, and overall SES. Among patients with HPV-positive OPC, never/light smokers had more than 5 times the odds of having at least a bachelor's degree and being in the highest level of SES compared with smokers. Patients with HPV-positive OPC and those with higher levels of education and SES had higher numbers of lifetime any and oral sex partners, although not all of these differences were significant.
  
  
  CONCLUSIONS
  Socioeconomic differences among subgroups of OPC patients have implications for OPC prevention efforts, including tobacco cessation, behavior modification, and vaccination programs.
authors.affiliation: Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, United States. Electronic address: kdahlstrom@mdanderson.org.
authors.forename: Kristina R
authors.initials: KR
authors.lastname: Dahlstrom
authors.affiliation: Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
authors.forename: Diana
authors.initials: D
authors.lastname: Bell
authors.affiliation: Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, United States; Department of Otolaryngology, Louisiana State University Health Sciences Center, New Orleans, LA, United States.
authors.forename: Duncan
authors.initials: D
authors.lastname: Hanby
authors.affiliation: Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, United States; Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
authors.forename: Guojun
authors.initials: G
authors.lastname: Li
authors.affiliation: Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
authors.forename: Li-E
authors.initials: LE
authors.lastname: Wang
authors.affiliation: Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States; Department of Medicine, Duke University School of Medicine and Duke Cancer Institute, Duke University Medical Center, Durham, NC, United States.
authors.forename: Qingyi
authors.initials: Q
authors.lastname: Wei
authors.affiliation: Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
authors.forename: Michelle D
authors.initials: MD
authors.lastname: Williams
authors.affiliation: Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, United States; Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
authors.forename: Erich M
authors.initials: EM
authors.lastname: Sturgis
mesh_terms: D000428:Alcohol Drinking / Q000453:epidemiology*; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology*; D005260:Female; D052162:Human papillomavirus 16 / Q000378:metabolism; D006801:Humans; D017403:In Situ Hybridization; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009959:Oropharyngeal Neoplasms / Q000453:epidemiology*; D030361:Papillomavirus Infections / Q000453:epidemiology*; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D012307:Risk Factors; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012907:Smoking / Q000453:epidemiology*; D012959:Socioeconomic Factors; D013781:Texas / Q000453:epidemiology
keywords: Behavioral epidemiology; Demography; Head and neck neoplasms; Head and neck/oral cancers; Human papillomavirus; Oropharyngeal cancer; Risk factors; Socioeconomic factors