{
  "abstract": "Patients with history of neck radiation for Human Papilloma Virus (HPV)-associated head and neck cancer experience rapid progression of carotid artery stenosis. The present study sought to determine whether screening and treating asymptomatic carotid artery stenosis in patients with a history of neck radiation is cost-effective. This study is a cost-utility analysis using a probabilistic Markov model over a thirty-year time horizon assessing carotid screening and treatment to avoid neurologic consequences of neck radiation for HPV-associated head and neck cancer. A strategy of no carotid surveillance was associated with a 14.8% cumulative risk of stroke and a strategy of ultrasound surveillance and treatment with TCAR was associated with a 3.0% cumulative risk of stroke. The latter had a median incremental cost of $1.04 million USD and provided a median 39.1 additional QALYs, resulting in a median incremental cost-effectiveness ratio of $26,556 per QALY. In conclusion, this study suggests that ultrasound surveillance and treatment with TCAR for asymptomatic carotid artery stenosis is likely to be cost-effective for patients who have been successfully treated with radiation therapy for HPV-associated head and neck cancer.",
  "abstract_shown": true,
  "affiliations": [
    "Baylor College of Medicine"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "name": "E. K. Greenleaf"
    },
    {
      "name": "V. Sandulache"
    },
    {
      "name": "S. P. R. Manikonda"
    },
    {
      "affs": [
        0
      ],
      "name": "N. R. Barshes"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/3v04n6zrh7dan.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.09.01.26361951",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.09.01.26361951v1.full",
  "id": "3v04n6zrh7dan",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.09.01.26361951v1",
  "language": null,
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "surgery"
    ],
    [
      "openalex",
      "2740|Cerebrovascular and Carotid Artery Diseases"
    ]
  ],
  "openalex": "W7208775239",
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.09.01.26361951v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-01",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/3v04n6zrh7dan.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:47Z",
      "native_id": "10.64898/2026.09.01.26361951",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.09.01.26361951v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:surgery",
      "subfield": "surgery"
    }
  ],
  "title": "Screening and Treatment of Carotid Stenosis in Patients with HPV-Associated Oropharyngeal Cancer",
  "title_text": "Screening and Treatment of Carotid Stenosis in Patients with HPV-Associated Oropharyngeal Cancer",
  "type": "preprint",
  "updated_at": "2026-10-30T12:17:47Z",
  "url": "https://research.draconitic.com/paper/3v04n6zrh7dan",
  "venue": "medRxiv",
  "versions": []
}