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HPV-Related Cancers after Solid Organ Transplantation in the US
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  • Pubmed ID:
  • Pubmed Central ID:
  • 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.

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  • 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
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