Systematic review and meta-analysis of accuracy of salivary circulating HPV DNA in detecting oropharyngeal cancer

Circulating tumor human papillomavirus DNA (ctHPV DNA) can be isolated from plasma or saliva, with the latter offering reduced invasiveness. Systematic review and meta-analysis included 6 studies (263 patients) with moderate heterogeneity (I²=36%) and low risk of bias. Pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio values demonstrated the test to be more specific than sensitive. Area under the associated summary receiver operating characteristic curve revealed the test to have acceptable accuracy. The authors conclude that salivary ctHPV DNA is an acceptably specific test in detecting HPV-associated OPC.