Early detection of head and neck squamous cell carcinoma (HNSCC) remains challenging because tissue biopsy is invasive and unsuitable for repeated monitoring or large-scale screening. This study systematically evaluated the diagnostic accuracy of human papillomavirus (HPV) DNA detection in oral gargle and rinse samples for HNSCC. This meta-analysis followed PRISMA guidelines and included 10 studies with 1315 participants. Pooled sensitivity, specificity, summary receiver operating characteristic (SROC), and diagnostic odds ratios (DOR) were calculated using random-effects models. Comprehensive subgroup analyses were conducted to explore pre-analytical and analytical heterogeneity. Pooled sensitivity and specificity were 0.68 (95% CI: 0.58–0.79) and 0.91 (95% CI: 0.88–0.95), respectively, with an AUC of 0.91. Higher pooled sensitivity was observed in subgroups using smaller collection volumes (≤10 mL), non-SPF10 PCR-based detection methods, and HPV16-specific targets, whereas specificity remained consistently high across subgroups. Fagan’s nomogram showed that the test offers greater clinical value for ruling in than ruling out the disease. Oral HPV DNA testing via gargle and rinse samples shows high specificity but moderate, highly variable sensitivity. Therefore, it functions best as a non-invasive, supplementary tool for triage or monitoring, rather than as a standalone early detection or rule-out method for HNSCC.
Wijaya et al. (Tue,) studied this question.
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