Lead time to recurrence after posttreatment plasma and saliva HPV DNA testing in patients with low-risk HPV oropharynx cancer

Recent studies have shown promise in the use of HPV DNA detection in saliva and plasma as a factor associated with a future diagnosis of HPV-positive oropharynx cancer (HPVOPC). However, the use of plasma and salivary HPV DNA detection in defining the risk for recurrence in the context of a prospective trial coupled with standardized clinical surveillance has not been reported. In a cohort study of 233 patients with low-risk HPVOPC from a prospective clinical trial, the sensitivity and specificity of plasma and salivary rinse HPV DNA assays for detecting recurrence were 65% and 87%, respectively. The mean (SD) lead time from positive test to recurrence dat was 122 (169.8) days. The authors conclude that posttreatment presence of HPV DNA in plasma and salivary rinses is associated with recurrence and potentially offers an opportunity for earlier detection of recurrence.