Skip to main content
AAO-HNSF 2025 Annual Meeting & OTO EXPO Main banner
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Rate ePoster
Video

Head and Neck Surgery

(A595) Patients with Primary Immunodeficiencies Have Higher Rates of Head and Neck Cancer and Poorer Outcomes

Monday, October 13, 2025
12:00 PM - 1:00 PM EDT
Location: OTO EXPO, Posters

    Presenting Author(s)

  • Jonathan D. West, MD

    Resident
    University of Southern California/LAC USC Med Ctr
    Los Angeles, California, United States

    • Co-Author(s)

  • Talia A. Wenger, BA

    Medical Student
    Keck School of Medicine
    South Pasadena, California, United States

    • Co-Author(s)

  • Casey Collet, MD

    Resident
    Caruso Department of Otolaryngology - Head and Neck Surgery
    Los Angeles , California, United States

    • Senior Author(s)

  • US

    Uttam K. Sinha, MD

    Professor
    Caruso Department of Otolaryngology - Head and Neck Surgery, United States

Disclosure(s):
Talia A. Wenger, BA: No relevant relationships to disclose.
Casey Collet, MD: No relevant relationships to disclose.
Jonathan D. West, MD: No relevant relationships to disclose.


Introduction: Primary immunodeficiencies (PI) are characterized by immune system dysfunction, which can increase susceptibility to certain cancers. Similarly, patients with acquired immunodeficiency due to HIV infection have a higher incidence of malignancies, including head and neck cancer (HNC). However, the association between PI and HNC risk remains unclear. We aimed to compare the incidence of HNC in patients with PI to national age-adjusted risk and assess clinical outcomes of PI patients who develop HNC.

Methods: We analyzed SEER Research Data (1975-2021) to determine age-adjusted risk of HNC in the general US population. TriNetX, a large database of deidentified electronic health records, was used to identify a cohort of patients with PI. Measures of association were applied to determine HNC rate. Two propensity-matched cohorts of HNC patients – with and without PI – were created based on demographics and tobacco and alcohol use. Primary outcome was rate of HNC. Secondary outcomes were rate of lung metastases and mortality, and determined by Kaplan-Meier and measures of association analyses. Analysis was completed in January 2025.

Results: Compared to the general US population, patients with PI have significantly higher rates of HNC overall (791/100,000 vs. 11.17/100,000, respectively, p< 0.0001), and at all sub sites. When stratified by age, all groups of PI patients 1-year and older had significantly higher rates of HNC than US age-adjusted risk. HNC patients with PI had significantly higher rates of lung metastases (RR 1.65, 95% Cl 1.50-1.82) and mortality (HR 1.58, 95% Cl 1.50-1.66) compared to HNC patients without PI.

Conclusions: Risk of HNC amongst patients with PI is significantly greater than the US population overall, at all sub sites and amongst age groups 1-year old and older. Patients with PI who develop HNC have higher rates of lung metastases and mortality. These findings emphasize the need for further research into the mechanism of HNC development in the congenitally immunosuppressed environment and suggest the need for updated clinical guidelines to ensure appropriate HNC screening for those with PI.