BACKGROUND Human papillomavirus (HPV) is a well-established prognostic marker for oropharyngeal squamous cell cancer (OPSCC). Because of the limited numbers of women and nonwhites in studies to date, sex and racial/ethnic differences in prognosis have not been well explored. In this study, survival differences were explored by the tumor HPV status among 1) patients with OPSCCs by sex and race and 2) patients with nonoropharyngeal (non-OP) head and neck squamous cell cancers (HNSCCs). METHODS This retrospective, multi-institution study included OPSCCs and non-OP HNSCCs of the oral cavity, larynx, and nasopharynx diagnosed from 1995 to 2012. Race/ethnicity was categorized as white non-Hispanic, black non-Hispanic, Asian non-Hispanic, and Hispanic of any race. Tumors were centrally tested for p16 overexpression and the presence of HPV by HPV16 DNA and high-risk HPV E6/E7 messenger RNA in situ hybridization. Kaplan-Meier and Cox proportional hazards models were used to evaluate overall survival (OS). RESULTS The study population included 239 patients with OPSCC and 621 patients with non-OP HNSCC with a median follow-up time of 3.5 years. After adjustments for the tumor HPV status, age, current tobacco use, and stage, the risk of death was lower for women versus men with OPSCC (adjusted hazard ratio, 0.55; P =.04). The results were similar with p16. In contrast, for non-OP HNSCCs, HPV positivity, p16 positivity, and sex were not associated with OS. CONCLUSIONS For OPSCC, there are differences in survival by sex, even after the tumor HPV status has been taken into account. For non-OP HNSCC, the HPV status and the p16 status are not of prognostic significance.

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Long-term cancer survivors with lymphedema may face up to 112% higher out-of-pocket costs than those without lymphedema, which influences lymphedema management, and has lasting impact on savings and productivity. Findings reinforce the need for actions at policy, provider, and individual patient levels, to reduce lymphedema costs. Future work should explore patient-driven recommendations to reduce economic burden after cancer.

NCT00994019.

The precipitation in Sichuan Basin (SB), China, exhibits pronounced diurnal variation, including minimum rainfall in daytime and a prominent peak near midnight. This study investigates the primary mechanism of precipitation diurnal variation in SB using forecasts from three summer months of 2013 produced at a 4‐km grid spacing. The model forecasts reproduce the observed spatial distributions and diurnal cycles well, including the peak precipitation in SB at around 02 local solar time (LST). Contrary to the common belief that emphasizes the solenoidal effects associated with the Tibetan and Yunnan‐Guizhou Plateaus, prominent diurnal inertial oscillations of boundary layer south‐southwesterly low‐level jet into SB are shown to play more important roles in modulating the diurnal cycles of precipitation in SB. A basinwide moisture budget analysis is performed to reveal that the moisture flux from the southeast side of the basin dominates within the diurnal oscillations of the net moisture flux into the basin, and the much enhanced nocturnal low‐level jet plays a crucial role in the formation of nocturnal precipitation within the basin. The net moisture flux into SB reaches maximum at around 22 LST, the time boundary layer perturbation winds from the daily mean in the direction normal to the southeastern boundary of SB reach maximum, which is about 4 hr before precipitation peak at around 02 LST. Shallow thermally forced nighttime downslope flows and daytime upslope flows on the Tibetan Plateau and Yunnan‐Guizhou Plateau slopes contribute only a small portion of moisture fluxes through the basin boundaries.