Gender disparities on overall survival rates in HPV-associated head and neck cancer: a systematic review and meta-analysis

Background: The incidence of HPV-associated head and neck cancers, especially in the oropharyngeal region, is rising sharply, raising substantial clinical and public health concerns. These cancers are distinct from those caused by other etiologies such as tobacco and alcohol due to the unique prognosis of HPV-positive cases. Despite their generally better prognosis, there is significant uncertainty regarding the variation in survival outcomes between genders. This study aims to closely examine and understand gender differences in survival rates among patients with HPV-associated head and neck cancers, exploring potential disparities to inform treatment strategies and improve patient outcomes. Methods: A systematic review and meta-analysis were conducted using data from 13 studies involving 203,346 HNC patients. The studies were sourced from PubMed, Embase, and Web of Science, covering research until May 2024. The analysis involved calculating pooled hazard ratios (HRs) for survival, assessing heterogeneity and publication bias using the I² statistic, funnel plots, and Egger’s test. Results: The findings showed a slight, non-significant survival advantage for females in HPV-positive HNCs (HR 0.952). In HPV-negative HNCs, there was also no significant gender difference in survival (HR 1.053). The study noted high heterogeneity and significant publication bias. Conclusions: No significant gender disparities in survival for HPV-positive or HPV-negative HNCs, suggesting the need for personalized care strategies beyond gender considerations.