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Scientific Oral Presentation

Head and Neck Surgery

ACE Inhibitors, Arbs, and Head and Neck Cancer: Associations with Incidence and Survival

Monday, October 19, 2026
4:30 PM - 4:36 PM PT
Location: West Exhibit Hall A, Learning Zone 3

    Presenting Author(s)

  • SI

    Sudhanvan Iyer, BSA

    Medical Student
    The University of Texas Medical Branch
    Pearland, TX, United States

    • Co-Author(s)

  • LP

    Lorelai Pop, BA

    Ms.
    University of Texas Medical Branch at Galveston, Texas, United States

  • Delaney S. Clark, n/a

    Medical Student
    The University of Texas Medical Branch
    Galveston, TX, United States

  • Robert E. Africa, MD

    Resident
    The University of Texas Medical Branch
    Galveston, TX, United States

    • Senior Author(s)

  • Viran J. Ranasinghe, MD

    Assistant Professor
    The University of Texas Medical Branch
    Galveston, TX, United States

Disclosure(s):
Sudhanvan Iyer, BSA:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Viran J. Ranasinghe, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Angiotensin-converting enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARBs) are commonly used medications for hypertension that have been found by researchers to have potential anti-cancer effects. This study evaluates the association between ACEi/ARB use and the development of Head and Neck Cancer (HNC) in cancer-free patients, as well as mortality after HNC diagnosis.

Methods: We conducted a retrospective cohort analysis using TriNetX, a federated multi-institutional electronic health record network, with data from 2005 - 2025. To investigate the outcomes of HNC incidence and mortality, two analyses were performed. The first examined HNC incidence among cancer-free patients with use of ACEi/ARB versus without. The second analyzed mortality among HNC patients stratified by ACEi/ARB exposure status (historical use, current use, anytime use, and no use). Cohorts were balanced using 1:1 propensity score matching across 26 covariates including demographics, hypertension, and tobacco use. Risk ratios (RR) with 95% confidence intervals (CI) were calculated.

Results: After matching, each cohort included 264,401 patients with comparable demographics and comorbidity burden. HNC incidence was significantly lower in patients with prior ACEi/ARB use (RR: 0.874; 95% CI: 0.795 - 0.961). Following HNC diagnosis, compared to the no ACEi/ARB use group, mortality was lower in the historical use (RR: 0.734; 95% CI: 0.698 - 0.773), current use (RR: 0.801; 95% CI: 0.765 - 0.840), and anytime use (RR: 0.808; 95% CI: 0.774 - 0.843) groups. Current users also had improved survival compared to historical users (RR: 0.801; 95% CI: 0.765 - 0.840). Trends persisted at 1, 3, 5, and >5 years follow up.

Conclusions: ACEi/ARBs are associated with reduced incidence of HNC and improved survival following diagnosis. These effects may reflect modulation of the renin-angiotensin system, including inhibition of angiogenesis, reduction of pro-inflammatory signaling, and suppression of tumor cell proliferation. Our findings support prospective studies to evaluate ACEi/ARB therapy as a potential adjunct in HNC management.