{"doi":"10.1093/jnci/djaf033","title":"Impact of screening for human papillomavirus-positive oropharyngeal cancers: a microsimulation-based modeling study","abstract":"BACKGROUND: We estimated the impact of screening on morbidity and mortality of human papillomavirus (HPV)16-positive oropharyngeal cancer among US men aged 45-79 years. METHODS: We developed an individual-level, state-transition natural history microsimulation model to estimate the impact of screening using oral HPV16 detection, HPV16-E6 antibody detection, and transcervical ultrasound of neck/oropharynx. We compared clinical detection to counterfactual screen detection for cancer stage, single- vs multiple-modality treatment, and survival. Screening scenarios encompassed 4 progression speeds across cancer stages (very slow, slow, fast, and very fast) and 4 screening frequencies. RESULTS: Among US men aged 45-79 years in 2021 (n = 54 881 311), 163 958 clinically diagnosed human papillomavirus (HPV)-positive oropharyngeal cancers and 32 009 deaths would occur through age 84 in the absence of screening. Assuming very-fast progression, 4%, 20%, 31%, and 60% of these cancers would be detected by one-off, 5-yearly, 3-yearly, and annual screening. Annual screening (very-fast progression) could reduce the number of cancers diagnosed at advanced stages (American Joint Committee on Cancer, 7th edition, stages III/IV: 90.0% with no screening vs 59.1%) and treated by multiple modalities (80.6% with no screening vs 50.6%). Cancer mortality would also be reduced by 36.2%, with a gain of 106 000 life-years. Annual screening would have a number needed to screen (NNS) of 561 per screen-detected cancer, 1118 per additional cancer treated by single modality, 4740 per death prevented, and 520 per life-year gained; such high NNS reflect potential inefficiency of population-level screening. CONCLUSIONS: If proven efficacious in randomized trials and cost-effective, screening for HPV-positive oropharyngeal cancers could provide considerable population-level reductions in advanced stage cancers, treatment-related morbidities, and mortality.","journal":"JNCI Journal of the National Cancer Institute","year":2025,"id":537964,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":4,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9471,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1424651,"name":"Gregory W Haber","orcid":null,"position":1,"is_corresponding":false},{"id":28634,"name":"Barry I. Graubard","orcid":"0000-0002-6787-1105","position":2,"is_corresponding":false},{"id":24637,"name":"Carole Fakhry","orcid":"0000-0002-5251-6178","position":3,"is_corresponding":false},{"id":463042,"name":"Nicole G. Campos","orcid":"0000-0002-0840-4339","position":4,"is_corresponding":false},{"id":314258,"name":"Emily A. Burger","orcid":"0000-0002-6657-5849","position":5,"is_corresponding":false},{"id":237721,"name":"Li C. Cheung","orcid":"0000-0003-1625-4331","position":6,"is_corresponding":false},{"id":237731,"name":"Hormuzd A. Katki","orcid":"0000-0003-2002-0095","position":7,"is_corresponding":false},{"id":32361,"name":"Maura L. Gillison","orcid":"0000-0002-8145-5749","position":8,"is_corresponding":false},{"id":453584,"name":"Anil K. Chaturvedi","orcid":"0000-0003-2696-8899","position":9,"is_corresponding":false},{"id":420942,"name":"Rebecca Landy","orcid":"0000-0003-4042-4820","position":0,"is_corresponding":true}],"reference_count":37,"raw_metadata":null,"created_at":"2026-07-19T02:52:16.891390Z","pmid":"39913364","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}