Risk of Second HPV-Associated Cancer Among Survivors of HPV-Associated Cancers

Key Points

  • Individuals who had primary HPV-related cancer had an increased risk of HPV-related cancer in other sites later in life.
  • The risk for most types of second primary HPV-associated cancers is high after initial vaginal and vulvar cancers in women, after initial penile cancer in men, and after anal cancer in both women and men.
  • No association with secondary non-HPV–associated cancers was found.

A retrospective study led by researchers at Baylor College of Medicine and The University of Texas Health Science Center at Houston (UTHealth) School of Public Health found that survivors of human papillomavirus (HPV)-associated cancers have a high incidence of developing second HPV-related cancers. Their findings, reported by Suk et al in JAMA Network Open, suggest the need for increased screening for HPV-associated precancerous and early cancerous lesions among people who are survivors of the disease.

HPV is a risk factor for gynecologic, anogenital, and oropharyngeal cancers. Cervical cancer is the most common HPV-associated cancer in women and oropharyngeal cancers are the most common in men.

“HPV is a virally mediated cancer, so it makes sense if somebody is infected in one site with the virus, that they would be infected in other sites as well. It is important for people who have had one HPV-related cancer to know that they are at increased risk for HPV-related cancers in another site, and they are encouraged to have screening for these other cancers, if screening is available. Currently, screening is available for cervical and anal precancers,” said Elizabeth Chiao, MD, MPH, Professor of Medicine in the section of infectious diseases at Baylor and with the Houston VA Center for Innovations in Quality, Effectiveness and Safety, and a member Dan L. Duncan Comprehensive Cancer Center.

Study Findings

Researchers used data from the Surveillance, Epidemiology, and End Results (SEER) Program database to identify survivors of HPV-associated cancers diagnosed from January 1973 to December 2014. They then looked at patients who developed a second primary HPV-associated cancer at the same site or a different site at least 2 months after the diagnosis.

They found that individuals who had primary HPV-related cancer had an increased risk of HPV-related cancer in other sites later in life.

According to the study results, the risk for most types of second primary HPV-associated cancers is high after initial vaginal and vulvar cancers in women, after initial penile cancer in men, and after anal cancer in both women and men. No association with secondary non-HPV–associated cancers was found.

The researchers recommend investigating the efficacy of screening and prevention measures for survivors of HPV-associated cancers. They also recommend being vaccinated against HPV. The vaccination series can begin at 9 years of age in males and females and can go through age 26 for females and age 21 in males.

“Future research needs to be prioritized to determine effective as well as cost-effective ways to screen for HPV-associated second cancers in this high-risk group,” said researchers.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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