Novel HPV Associated Oropharyngeal Squamous Cell Carcinoma Surveillance DNA Assay Cost Analysis

Abstract

ObjectivesWe aim to propose a modified surveillance strategy using a novel blood assay that detects plasma circulating tumor‐specific HPV DNA with reported 100% NPV and 94% PPV as the main method of detection to understand the cost implications of potentially avoiding routine imaging and surveillance visits at our institution.MethodsWe performed a retrospective chart review focusing on recurrences in p16+ patients with OPSCC and defined two surveillance strategies: “Strategy A", follow‐up visits with flexible laryngoscopy (FL) plus regular imaging studies; “Strategy B", follow‐up visits with FL plus regular NavDx assays and imaging used at the discretion of the physician(s) in cases of high clinical suspicion.ResultsOf the p16+ OPSCC patients (n = 214), 23 had confirmed recurrence (11%). Standard work‐flow model determined 72 imaging studies and 2198 physical examinations with FL were needed to detect one recurrence. Potential individual patient cost reduction during surveillance was 42%.ConclusionImplementing NavDx for HPV + OPSCC surveillance would benefit patients by reducing costs and unnecessary diagnostic testing.Level of EvidenceStep/Level 3 Laryngoscope, 133:3006–3012, 2023