{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T09:50:09Z","timestamp":1791625809545,"version":"4.3.4"},"reference-count":21,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T00:00:00Z","timestamp":1778716800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T00:00:00Z","timestamp":1778716800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp;amp; Neck"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Timely referral to subspecialty care remains critical for expedited work up and treatment of HPV\n                      <jats:sup>+<\/jats:sup>\n                      oropharyngeal carcinoma (OPSCC). It is not known if there have been changes in time to diagnosis as the incidence of this disease rises.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Retrospective cohort study of 312 patients treated for HPV\n                      <jats:sup>+<\/jats:sup>\n                      OPSCC at a tertiary referral clinic between 2013 and 2022.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      There was a significant difference in time to diagnosis based on year of presentation (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). More patients presented with early\u2010stage disease (AJCC 7 Stage I or II) over time (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002). Presenting symptom (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.021) and patient location \u2265\u200950\u2009miles from our tertiary referral clinic (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.039) also affected time to diagnosis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Time to diagnosis of HPV\n                      <jats:sup>+<\/jats:sup>\n                      OPSCC changed based on year of presentation, and a higher proportion of patients presented with early\u2010stage disease in more recent years. This may reflect an increased public awareness of HPV\n                      <jats:sup>+<\/jats:sup>\n                      OPSCC and its symptoms.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hed.70318","type":"journal-article","created":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T01:49:21Z","timestamp":1778809761000},"page":"3016-3022","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Changes in Time to Diagnosis of\n                    <scp>HPV<\/scp>\n                    <sup>+<\/sup>\n                    Oropharyngeal Squamous Cell Carcinoma"],"prefix":"10.1002","volume":"48","author":[{"given":"Julia","family":"Howard","sequence":"first","affiliation":[{"name":"California Northstate University College of Medicine  Elk Grove California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaheryar","family":"Asad","sequence":"additional","affiliation":[{"name":"California Northstate University College of Medicine  Elk Grove California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9360-3235","authenticated-orcid":false,"given":"Danielle M.","family":"Gillard","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8180-4542","authenticated-orcid":false,"given":"Katherine C.","family":"Wai","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary 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