University of Florida, Gainesville, FL
Ryan Suk , Parag Mahale , Kalyani Sonawane , Andrew G. Sikora , Jagpreet Chhatwal , Kathleen M. Schmeler , Keith Sigel , Scott B. Cantor , Elizabeth Chiao , Ashish A Deshmukh
Background: For the HPV-associated index cancer survivors, persistent HPV infection may remain a risk factor for preventable HPV-associated second primary cancer (HPV-SPC). However, the risk of HPV-SPCs among HPV-associated index cancer patients has not been well documented. Methods: Longitudinal data from 9 cancer registries of the Surveillance, Epidemiology, and End Results (SEER) database were used to identify cases of HPV-associated cancers diagnosed from 1973 to 2014. The HPV-SPC risk was quantified using standard incidence ratios (SIRs) and excess absolute risk (EAR) per 10,000 person-years at risk (PYR). Results: The SIRs for second primary HPV-related cancers after index HPV-related cancers among women and men were 3.3 (95% CI 3.2 to 3.4) and 15.8 (95% CI, 15.0 to 16.7), respectively; the EAR was 6.0 and 51.4 for women and men, respectively. When the same site second primary cancers were excluded, the risk remain significant both among women (SIR = 2.7) and men (SIR = 2.3). The risk of HPV-SPC was highest for oropharyngeal cancer both among women (SIR = 20.6; EAR = 83.8) and men (SIR = 18.8; EAR = 64.3), and lowest for cervical (SIR = 2.0; EAR = 2.4) and penile (SIR = 7.0; EAR = 20.7) cancer. Conclusions: The risk of developing HPV-SPC among HPV-related cancer survivors is significant, implying that HPV might be a cause for developing HPV-SPC. Our findings have the potential to inform surveillance recommendations among HPV-related cancer survivors.
Index HPV Cancers | Women | Men | |||||||
---|---|---|---|---|---|---|---|---|---|
All HPV-SPC | All HPV-SPC (same site excluded) | All HPV-SPC | All HPV-SPC (same site excluded) | ||||||
SIR (95% CI) | EAR | SIR (95% CI) | EAR | SIR (95% CI) | EAR | SIR (95% CI) | EAR | ||
All HPV-related cancers | 3.3 (3.2-3.4) | 6.0 | 2.7 (2.5-2.8) | 2.3 | 15.8 (15.0-16.7) | 51.4 | 2.3 (1.8-2.9) | 1.6 | |
Cervical | 2.0 (1.9-2.1) | 2.4 | 2.5 (2.3-2.7) | 1.8 | NA | NA | NA | NA | |
Vaginal | 6.6 (5.2-8.3) | 20.5 | 3.9 (2.8-5.3) | 10.0 | NA | NA | NA | NA | |
Vulvar | 9.5 (8.7-10.3) | 28.0 | 4.1 (3.6-4.7) | 8.5 | NA | NA | NA | NA | |
Oropharyngeal | 20.6 (19.1-22.2) | 83.8 | 1.7 (1.2-2.3) | 1.9 | 18.8 (17.7-19.9) | 64.3 | 1.7 (0.9-2.7) | 0.4 | |
Anal | 6.1 (5.0-7.4) | 20.8 | 3.5 (2.6-4.6) | 9.0 | 10.4 (8.5-12.5) | 26.6 | 2.1 (1.3-3.3) | 2.9 | |
Penile | NA | NA | NA | NA | 7.0 (5.7-8.7) | 20.7 | 2.9 (2.0-4.0) | 5.8 |
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Abstract Disclosures
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