Abstract

Background: Oropharyngeal cancer (OPC) incidence has been increasing among males in the United States, reflecting a complex interplay among social, behavioral, and biological determinants of health. This study aimed to quantify cumulative risk profiles and their relationship with the burden of comorbid conditions in men with OPC using the All of Us Research Program cohort. Methods: We developed a cumulative risk index from nine biological, clinical, and social variables for males with OPC in the United States. Comorbidity burden was measured by the number of unique comorbid diagnoses per patient, excluding HIV/AIDS and primary OPC to reduce circularity. Poisson regression was performed to estimate incidence rate ratios (IRR) for comorbidity by risk group/count. Results: Under strict criteria requiring data for each risk factor, mean comorbidity was 1.90 in the low-risk and 2.29 in the moderate-risk groups; in an inclusive, ‘liberal’ analysis, most cases (74%) were moderate risk with much lower mean comorbidities (mean = 0.050–0.205), with only 5% having any comorbidity recorded. Each additional risk factor was associated with an 81% increase in unique comorbidities (IRR = 1.81, 95% CI: 1.16–2.91; p = 0.01). The high-risk group had substantially higher comorbidity but comprised only two individuals. The most common comorbid diagnoses were essential hypertension and hyperlipidemia, and the most frequent risk factor co-occurrence was having a family history of head and neck cancer and having no insurance. Conclusions: Our analysis demonstrated male OPC patients to have multiple risk factors, but comorbidity burden was concentrated in a small minority, supporting the need for risk stratification and integrated, multidomain prevention and care strategies.

IPC Classification

Keywords