{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T20:15:59Z","timestamp":1760472959320,"version":"3.40.5"},"reference-count":23,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,1,12]],"date-time":"2021-01-12T00:00:00Z","timestamp":1610409600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Human papilloma virus (HPV)\u2010associated oropharyngeal squamous cell carcinoma (OPSCC) continues to increase in incidence. Patients are younger, non\u2010smokers and most commonly present with a neck mass often with no other symptoms. This altered presentation compared with non\u2010HPV OPSCC may not be recognized by medical practitioners, leading to delayed diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with histopathological confirmation of OPSCC and known HPV and\/or P16 status who presented to our institution between 2012\u20132017 inclusive were included in the study. Demographic data, tumour characteristics and presenting symptoms were retrospectivxely obtained from both electronic\u2010 and paper\u2010based records. Descriptive statistics were used to report demographic data and the two sample <jats:italic>t<\/jats:italic>\u2010test and Fisher's exact test were used to compare groups based on HPV status. Time to diagnosis was also reported.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 184 patients were included in the study. The majority of patients were male (85.4%) and HPV + (85.3%). The tonsillar complex (53.8%) and tongue base (42.4%) were the most common primary sites. HPV+ patients were less likely to smoke (17.8%) and they commonly presented with a neck mass (39.5% alone or with other symptoms 61.2%). Time to diagnosis in the HPV+ group was longer (15\u2009weeks).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our review has highlighted the altered presentation of OPSCC due to the increased incidence of HPV infection. We showed a delayed time to diagnosis in HPV+ OPSCC compared with non\u2010HPV disease. This confirms the importance of focusing our efforts on educating medical practitioners and creating further awareness to facilitate early detection and treatment.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.16537","type":"journal-article","created":{"date-parts":[[2021,1,15]],"date-time":"2021-01-15T11:44:03Z","timestamp":1610711043000},"page":"1240-1245","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Altered presentation of oropharyngeal cancer, a 6\u2010year review"],"prefix":"10.1111","volume":"91","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9522-0812","authenticated-orcid":false,"given":"Peter","family":"Floros","sequence":"first","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery St Vincent's Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amshuman","family":"Rao","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery St Vincent's Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachael A.","family":"McCloy","sequence":"additional","affiliation":[{"name":"Single Cell and Computational Genomics Lab The Garvan Institute of Medical Research  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hao\u2010Wen","family":"Sim","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology The Kinghorn Cancer Centre, St Vincent's Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Venessa T.","family":"Chin","sequence":"additional","affiliation":[{"name":"Single Cell and Computational Genomics Lab The Garvan Institute of Medical Research  Sydney New South Wales Australia"},{"name":"Department of Medical Oncology The Kinghorn Cancer Centre, St Vincent's Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brett C.","family":"Leavers","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery St Vincent's Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia A.","family":"Crawford","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery St Vincent's Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard M.","family":"Gallagher","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery St Vincent's Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,1,12]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2014.141"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016489.2017.1405279"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19890815)64:4<932::AID-CNCR2820640428>3.0.CO;2-Y"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.128.3.313"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/0964-1955(94)90086-8"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2015.06.005"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6603044"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.130.1.45"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-4486.2012.02464.x"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.050623"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0912217"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djn011"},{"key":"e_1_2_7_14_1","unstructured":"Australian Department of Health.Australian Alcohol Guidelines the Australian Standard Drink. 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