How Would You Treat? A Case-Vignette Study of Provider Treatment Preferences in Human Papillomavirus-Mediated Oropharyngeal Cancer.

Abstract

Current guidelines recommend surgical resection, definitive radiotherapy (RT), or concurrent chemoradiotherapy (CRT) for human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC). This study aimed to provide insight into practice patterns of providers who treat HPV-associated OPSCC. A five case-vignette survey was distributed to head and neck surgical oncologists, medical oncologists, and radiation oncologists who treat head and neck cancer at NCI-Designated Comprehensive Cancer Centers. Providers were asked to recommend management. Eighty-three providers completed the survey (14% response rate). Head and neck surgeons had a 60% surgical recommendation rate while medical and radiation oncologists had a 58% non-surgical recommendation rate. Radiation oncologists were more likely to recommend RT and CRT, and medical oncologists were more likely to recommend CRT over surgery compared to head and neck surgeons. Provider specialty-specific biases influence treatment recommendations and emphasizes the importance of a multidisciplinary approach to head and neck cancer care.