Human Papillomavirus-Associated Subsequent Malignancies among Long-Term Survivors of Pediatric and Young Adult Cancers
Open Access
- 5 August 2013
- journal article
- research article
- Published by Public Library of Science (PLoS) in PLOS ONE
- Vol. 8 (8), e70349
- https://doi.org/10.1371/journal.pone.0070349
Abstract
Long-term survivors of pediatric and young adult (PAYA) cancers have a high incidence of subsequent neoplasms, but few risk factors other than cancer treatment have been identified. We aimed to describe the burden of human papillomavirus (HPV)-associated malignancies among survivors of PAYA cancers to assess whether HPV infections might be a reasonable area of future etiologic research on subsequent malignancies in this population. We used longitudinal data from 9 population-based registries of the Surveillance, Epidemiology, and End Results program collected between 1973 and 2010 to assemble a cohort of individuals who were diagnosed with any cancer between the ages of 0 and 29 years and survived at least 5 years post-diagnosis. We estimated sex-specific standardized incidence ratios (SIRs) with corresponding 95% confidence limits (CL) of HPV-associated subsequent malignancies (cervical, vaginal, vulvar, penile, anal, tongue, tonsillar, and oropharyngeal). Our study population comprised 64,547 long-term survivors of PAYA cancers diagnosed between 1973 and 2010. Compared with females in the general US population, female PAYA cancer survivors had a 40% relative excess of HPV-associated malignancies overall (SIR = 1.4, 95% CL: 1.2, 1.8). Compared with males in the general US population, male PAYA cancer survivors had a 150% relative excess of HPV-associated malignancies overall (SIR = 2.5, 95% CL: 1.9, 3.4). Our findings suggest an excess of HPV-associated malignancies among PAYA cancer survivors compared with the general US population. We hypothesize that a portion of subsequent malignancies among PAYA cancer survivors may be directly attributable to HPV infection. This hypothesis warrants exploration in future studies.Keywords
This publication has 39 references indexed in Scilit:
- Annual Report to the Nation on the Status of Cancer, 1975–2009, Featuring the Burden and Trends in Human Papillomavirus (HPV)–Associated Cancers and HPV Vaccination Coverage LevelsJNCI Journal of the National Cancer Institute, 2013
- DNA repair polymorphisms influence the risk of second neoplasm after treatment of childhood acute lymphoblastic leukemiaZeitschrift für Krebsforschung und Klinische Onkologie, 2012
- Human papillomavirus, smoking, and head and neck cancerAmerican Journal of Otolaryngology, 2012
- Long-term risk for subsequent leukemia after treatment for childhood cancer: a report from the Childhood Cancer Survivor StudyBlood, 2011
- Subsequent Neoplasms in 5-Year Survivors of Childhood Cancer: The Childhood Cancer Survivor StudyJNCI Journal of the National Cancer Institute, 2010
- Risk of thyroid cancer in survivors of childhood cancer: Results from the British Childhood Cancer Survivor StudyInternational Journal of Cancer, 2009
- Competing Risk Regression Models for Epidemiologic DataAmerican Journal of Epidemiology, 2009
- The cancer screening practices of adult survivors of childhood cancerCancer, 2004
- Health Care of Young Adult Survivors of Childhood Cancer: A Report from the Childhood Cancer Survivor StudyAnnals of Family Medicine, 2004
- Predictors of Smoking Initiation and Cessation Among Childhood Cancer Survivors: A Report From the Childhood Cancer Survivor StudyJournal of Clinical Oncology, 2002