Circulating Tumor HPV DNA May Aid Risk Assessment With Oropharyngeal Cancer

Blood test for ctHPVDNA could improve risk evaluation for patients undergoing surgery

Apr. 16, 2026 at 1:12pm

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A highly detailed, translucent X-ray photograph showing the intricate bone and soft tissue structures of the human oropharynx, conveying the clinical nature of this diagnostic technology.An advanced imaging technique provides a revealing look at the complex anatomy of the oropharynx, potentially aiding in the early detection and risk assessment of HPV-related cancers.Columbus Today

A study published in JAMA Otolaryngology-Head & Neck Surgery found that a blood test for circulating tumor human papillomavirus DNA (ctHPVDNA) may improve risk assessment in patients undergoing surgery for HPV-related oropharyngeal cancer. The researchers assessed clinicopathologic variables associated with ctHPVDNA before and after surgery, and found that higher estimated glomerular filtration rate and higher pathologic N stage were independently associated with higher preoperative ctHPVDNA levels, while perineural invasion and pathologic extranodal extension were associated with lower ctHPVDNA levels.

Why it matters

Oropharyngeal cancer is a growing public health concern, with HPV infection being a major risk factor. Improved risk assessment tools could help guide treatment decisions and improve outcomes for patients with this disease. The findings from this study suggest that the ctHPVDNA blood test may provide valuable information to supplement traditional clinicopathologic factors in risk stratification.

The details

The study included 104 patients with HPV-mediated oropharyngeal squamous cell carcinoma who underwent upfront surgery. The researchers found that one in five patients (20.2%) had detectable postoperative ctHPVDNA, which was associated with factors like more than four positive lymph nodes, higher preoperative ctHPVDNA levels, perineural invasion, and pathologic extranodal extension. Three of 15 patients (20%) with detectable postoperative ctHPVDNA experienced recurrence, compared to 8 of 59 patients (13.6%) with undetectable ctHPVDNA.

  • The study was published online on April 2, 2026.

The players

Jack L. Birkenbeuel

A physician from The Ohio State University in Columbus who led the research study.

Catherine Haring

A co-author of the study, also from The Ohio State University.

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What they’re saying

“We found that the pretreatment ctDNA levels are influenced by tumor biology and kidney function. Postoperative ctDNA reflects both residual cancer and baseline tumor DNA levels. This means the test needs to be interpreted in context. A positive result after surgery may indicate higher risk, but a negative result does not always mean a patient is in the clear.”

— Catherine Haring, Co-author of the study

What’s next

Further research is needed to validate the use of the ctHPVDNA blood test in larger patient populations and to determine its optimal integration into clinical decision-making for patients with oropharyngeal cancer.

The takeaway

This study suggests that the ctHPVDNA blood test could be a valuable tool to improve risk assessment and guide treatment decisions for patients with HPV-related oropharyngeal cancer, but more research is needed to fully understand its clinical utility.