Elevated risk of human papillomavirus‐related second cancers in survivors of anal canal cancer

Nelson, Rebecca A.; Lai, Lily

doi:10.1002/cncr.30828

Cited by 15 publications

(14 citation statements)

References 27 publications

(60 reference statements)

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“…Albeit based on small numbers yielding wide confidence intervals, our assessment of risk was based on two separate analytic approaches resulting in similar estimates. Taken together, our results provide further support of the hypothesis of an increased risk of a second HPV-associated cancer in patients with penile cancer [14][15][16]26].…”

Section: Discussionsupporting

confidence: 84%

“…The risk of developing a second HPV-associated cancer after a primary HPV-associated cancer has been investigated previously [14][15][16][17]. It is well established that women diagnosed with cervical cancer are at an increased risk of a second HPV-associated cancer because of persistent HPV infection and cross-infection at multiple anatomic sites [18,19].…”

Section: Introductionmentioning

confidence: 99%

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Risk of second HPV-associated cancers in men with penile cancer

et al. 2021

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Purpose: The aim of this study was to examine the risk of HPV-associated oral cavity, oropharyngeal or anal cancer in men with penile cancer to test the hypothesis of an increased risk to develop a second HPV-associated cancer later in life. Material and methods: We conducted a population-based register study including all men in Sweden diagnosed with penile cancer between 2000 and 2012. For each patient, six men without penile cancer were matched based on age and county of residence. Data were retrieved from Swedish cancer and population registers, to assess the risk of oral cavity, oropharyngeal or anal cancer in patients with penile cancer. Cox proportional hazard models were used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs). Risks in men with penile cancer were also compared with the background Swedish male population by use of standardized incidence ratios. Results: In total, 1634 men with and 9804 without penile cancer were included in the study. Among men with penile cancer, four men were subsequently diagnosed with oral cavity cancer, one with oropharyngeal cancer and one with anal cancer. Corresponding numbers among the penile cancer-free men were ten, two and three, respectively. There was evidence of an increased risks of all three cancers under study with an HR of 2.84 (95% CI 0.89-9.06) for oral cavity cancer, 3.66 (95% CI 0.33-40.39) for oropharyngeal cancer and 2.34 (95% CI 0.24-22.47) for anal cancer. When comparing the incidence of these malignancies between penile cancer patients and the background population, the patterns of association were similar. Conclusions: Our findings indicate that men with penile cancer are at an increased risk of a second HPV-associated cancer of the oral cavity, oropharynx and anal canal. Considering that our study was based on small numbers reflecting the rarity of these cancers, larger studies are needed to confirm our findings.

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Section: Discussionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Risk of second HPV-associated cancers in men with penile cancer

et al. 2021

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“…Multiple primary malignancies in patients with anal squamous cell carcinoma patients present with localized disease which portends a 5-year relative survival rate of approximately 80% (7). After an index SCCA, the rate of developing an HPV-related SPM is significantly increased (8). A study from France found an increase in global SPM in men but not women after index SCCA, hypothesized to be due to the higher prevalence of human immunodeficiency virus (HIV) in men (9).…”

Section: Short Communicationmentioning

confidence: 99%

Multiple primary malignancies in patients with anal squamous cell carcinoma

Yegya-Raman

Kim

et al. 2018

J. Gastrointest. Oncol.

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Prior studies examining the risk of second primary malignancy (SPM) after a first primary cancer generally have used large datasets such as the Surveillance, Epidemiology, and End Results (SEER) registry and excluded survivors of previous primaries and developers of synchronous primaries. The goal of this study was to provide a more complete representation of multiple cancer risk in squamous cell carcinoma of the anus (SCCA) patients. A single-institution retrospective study of 46 patients treated definitively for SCCA between January 2006 and July 2017 was conducted. Of the 46 patients, 18 (39%) had either a primary malignancy before SCCA (n=9) or SPM after an index SCCA (n=9). Six patients had ≥3 total malignancies. In our cohort, patients without SPMs tended to die from SCCA recurrence, while patients with SPMs were more likely to die from their SPM than from SCCA. Our study suggests that patients with SCCA are often either survivors of previous cancers or develop later malignancies. Several risk factors may play a role including HPV infection, HPV-related or treatment-related immunosuppression, somatic mutations due to chemotherapy, and genetic factors. Patients with SCCA require lifelong surveillance given their elevated risk of malignancy. Future work should focus on identifying genomic or immunologic factors that may predispose SCCA patients to develop multiple primary malignancies.

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“…This reaffirms that HPV infection in one site is often associated with other sites of infection [43]. …”

Section: Anal Cancermentioning

confidence: 71%

New Insights into the Role of Human Papillomavirus in Anal Cancer and Anal Wart Development

Albuquerque

Medeiros

2019

Acta Cytologica

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Human papillomavirus is associated with several anogenital and oropharyngeal lesions, including warts, premalignant lesions, and cancer. There are specific groups that were identified as high-risk groups for anal squamous cell carcinoma and anal human papillomavirus infection, namely HIV-positive patients, men who have sex with men, women with genital tract neoplasia, and solid organ transplant recipients. Condylomas have classically been considered to be a benign lesion, with an exception made for the Buschke-Loewenstein tumor, but several publications have shown that a high percentage of condylomas harbor high-grade lesions. Due to the similarities between anal and cervical carcinogenesis, anal cancer screening based on anal cytology and referral to high-resolution anoscopy, in case of abnormalities, have been advocated. Testing for anal human papillomavirus is not routinely done in anal cancer screening, because of the very high prevalence in high-risk populations. The large majority of anal cancers are squamous cell carcinomas (SCC), and around 90% are attributed to human papillomavirus. Human papillomavirus positivity in anal SCC seems to have a prognostic value, with better survival in those patients with positive tumors. Prophylactic vaccination has been shown to be important for prevention of anal human papillomavirus-related lesions.

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Elevated risk of human papillomavirus‐related second cancers in survivors of anal canal cancer

Cited by 15 publications

References 27 publications

Risk of second HPV-associated cancers in men with penile cancer

Risk of second HPV-associated cancers in men with penile cancer

Multiple primary malignancies in patients with anal squamous cell carcinoma

New Insights into the Role of Human Papillomavirus in Anal Cancer and Anal Wart Development

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