HPV-Related Cancers after Solid Organ Transplantation in the US

Details

• Alternative Title:
  Am J Transplant
• Personal Author:
  Madeleine, M. M. ; Finch, J. L. ; Lynch, C. F. ; Goodman, M. T. ; Engels, E. A.
• Description:
  Transplant recipients have elevated cancer risk including risk of human papillomavirus (HPV)-associated cancers of the cervix, anus, penis, vagina, vulva and oropharynx. We examined the incidence of HPV-related cancers in 187 649 US recipients in the Transplant Cancer Match Study. Standardized incidence ratios (SIRs) compared incidence rates to the general population, and incidence rate ratios (IRRs) compared rates across transplant subgroups. We observed elevated incidence of HPV-related cancers (SIRs: in situ 3.3-20.3, invasive 2.2-7.3), except for invasive cervical cancer (SIR 1.0). Incidence increased with time since transplant for vulvar, anal and penile cancers (IRRs 2.1-4.6 for 5+ vs. <2 years). Immunophenotype, characterized by decreased incidence with HLA DRB1:13 and increased incidence with B:44, contributed to susceptibility at several sites. Use of specific immunosuppressive medications was variably associated with incidence; for example, tacrolimus, was associated with reduced incidence for some anogenital cancers (IRRs 0.4-0.7) but increased incidence of oropharyngeal cancer (IRR 2.1). Thus, specific features associated with recipient characteristics, transplanted organs and medications are associated with incidence of HPV-related cancers after transplant. The absence of increased incidence of invasive cervical cancer highlights the success of cervical screening in this population and suggests a need for screening for other HPV-related cancers.
• Subjects:
  Adolescent Adult Anus Neoplasms Cohort Studies Female Humans Immunosuppression Incidence Male Middle Aged Organ Transplantation Oropharyngeal Neoplasms Papillomavirus Infections Penile Neoplasms Registries Tacrolimus Uterine Cervical Neoplasms Vulvar Neoplasms Young Adult

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• Source:
  Am J Transplant. 13(12):3202-3209.
• Pubmed ID:
  24119294
• Pubmed Central ID:
  PMC4049182
• Document Type:
  Journal Article
• Funding:
  1U58 DP000807-01/DP/NCCDPHP CDC HHS/United States ; 5658DP000805-04/DP/NCCDPHP CDC HHS/United States ; 5U58/DP000808-05/DP/NCCDPHP CDC HHS/United States ; 5U58DP000812-03/DP/NCCDPHP CDC HHS/United States ; 5U58DP000817-05/DP/NCCDPHP CDC HHS/United States ; 5U58DP000824-04/DP/NCCDPHP CDC HHS/United States ; HHSN261201000024C/PHS HHS/United States ; HHSN261201000026C/PHS HHS/United States ; HHSN261201000027C/PHS HHS/United States ; HHSN261201000034C/PHS HHS/United States ; HHSN261201000035C/PHS HHS/United States ; HHSN261201000036C/PHS HHS/United States ; HHSN261201000037C/PHS HHS/United States ; HSN261201000032C/PHS HHS/United States ; N01-PC-35137/PC/NCI NIH HHS/United States ; N01-PC-35139/PC/NCI NIH HHS/United States ; N01-PC-35142/PC/NCI NIH HHS/United States ; N01-PC-35143/PC/NCI NIH HHS/United States ; N01-PC-54405/PC/NCI NIH HHS/United States ; P01 CA042792/CA/NCI NIH HHS/United States ; P30 CA086862/CA/NCI NIH HHS/United States ; U58 DP000848-04/DP/NCCDPHP CDC HHS/United States ; U58DP000832/DP/NCCDPHP CDC HHS/United States ; U58DP0038789/DP/NCCDPHP CDC HHS/United States
• Place as Subject:
  United States
• Volume:
  13
• Issue:
  12
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:9ecb2039abf62c9e732768b9d424cd4b3310090967705a2d0aeaeca9df6f3589
• Download URL:
  https://stacks.cdc.gov/view/cdc/29990/cdc_29990_DS1.pdf
• File Type:
  [PDF - 271.93 KB ]