Rates and Outcomes of Head and Neck Cancer Among Patients With Primary Immunodeficiency Disorders

OBJECTIVE: Patients with primary immunodeficiency disorders (PID) have increased hematological cancer risk but the risk of head and neck cancer (HNC) is not well-established. Here, we sought to compare the risk of HNC among patients with PID to that of the general population. Furthermore, we report overall outcomes among HNC patients with and without PID. STUDY DESIGN: Retrospective cohort study. SETTING: TriNetX, a database containing millions of deidentified health records, and Surveillance, Epidemiology, and End Results (SEER) 2017 to 2021. METHODS: A comparative analysis of HNC incidence among patients with PID versus the general population. Outcomes analyses were conducted on 1:1 propensity matched cohorts of patients with HNC with and without PID. RESULTS: Patients with PID had a significantly increased risk of HNC compared to the general population with an overall SIR (95% CI) of 6.55 (5.13-8.13) for oral cavity and pharynx cancer. Among patients with HNC, those with PID had a significantly increased risk of mortality (HR 1.39, 95% CI 1.17-1.66) and malnutrition (OR 1.34, 95% CI 1.21-1.49). CONCLUSION: Patients with PID have significantly increased incidence of HNC compared to the general population. Moreover, HNC patients with PID face an increased risk of post-operative complications and mortality.