The Impact of Human Papillomavirus Infection on Skin Cancer: A Population-Based Cohort Study

Abstract

Background This study investigated the correlation between a history of human papillomavirus (HPV) infection and skin cancer risk. Materials and Methods The study cohort comprised 26,919 patients with newly diagnosed HPV infection between 2000 and 2012; with the use of computer‐generated numbers, patients without previous HPV infection were randomly selected as the comparison cohort. The patients in the HPV infection cohort were matched to comparison individuals at a 1:4 ratio by demographic characteristics and comorbidities. All study individuals were followed up until they developed skin cancer, withdrew from the National Health Insurance program, were lost to follow‐up, or until the end of 2013. The primary outcome was subsequent skin cancer development. Cox proportional hazards regression analysis was used to analyze the risk of skin cancer with hazard ratios (HRs) and 95% confidence intervals (CIs) between the HPV and control cohort. Results The adjusted HR of skin cancer for patients with HPV relative to controls was 2.45 after adjusting sex, age and comorbidities. (95% CI, 1.44–4.18, p < .01). The subgroup analysis indicated that a patient with HPV infection had a significantly greater risk of skin cancer if they were aged >40 years. Notably, a risk of skin cancer was found in the group diagnosed with HPV within the first 5 years after the index date (adjusted HR, 3.12; with 95% CI, 1.58–5.54). Sensitivity analysis by propensity score, matching with balanced sex, age, and comorbidities, showed consistent results. Conclusion A history of HPV infection is associated with the development of subsequent skin cancer in Taiwanese subjects, and the risk wanes 5 years later. Implications for Practice In this Taiwan nationwide cohort study, there was a 2.45‐fold increased risk of developing new‐onset skin cancers for patients with incident human papillomavirus (HPV) infection, compared with the matched controls. Furthermore, the risk was noticeably significant among patients aged >40 years. A prominent risk of skin cancers was found in the group diagnosed with HPV within the first 5 years after the index date in this study. The results of this analysis may raise consensus on the effect of HPV infection on the risk of skin cancers. Clinicians are encouraged to implement prudently on the differential diagnosis of skin cancers and HPV prevention and treatment, especially in older patients.

Skin Cancer Research Goes Digital: Looking for Biomarkers within the Droplets

“…One of the prospective applications of ddPCR in skin cancer research may be in the field of preventive medicine. Established risk factors for skin cancer include environmental carcinogens, such as ultraviolet (UV) light exposure, immunosuppression, chronic inflammation, genetic background, and infection with certain human papillomavirus (HPV) genotypes [ 79 ]. A bourgeoning body of research highlights an etiologic relationship between HPV infection and skin cancer, particularly between types in genus β and SCC [ 80 , 81 ].…”

The Human Microbiota and Skin Cancer

“…Emerging studies have shown a possible link between SCC and human papillomavirus (HPV). A recent population-based study conducted in Taiwan has found an increased risk of HPV infection in patients with NMSC (adjusted hazard ratio, 2.59; 95% confidence interval [CI], 1.43-1.71) compared with controls [18]. A meta-analysis also found an increased risk of HPV infection in cutaneous SCC than in normal-appearing skin (pooled effect size, 3.43; 95% CI, 1.97-5.98) [19].…”

“…Several epidemiological studies have suggested the association between HPVs and melanoma. A population-based cohort study demonstrated that a HPV infection is associated with an increased risk of melanoma (adjusted hazard ratio, 17.1; 95% CI, 1.88-156) [18]. As a matter of fact, high-risk mucosal HPVs have been found in 27% of MM samples (skin biopsy) using PCR-ELISA [45].…”

Diagnostic and Therapeutic Uses of the Microbiome in the Field of Oncology

“…Staphylococcus aureus and Cutibacterium were associated with squamous cell carcinomas of the skin [ 161 , 162 ]. Some studies have also found an association between HPV and non-melanoma skin cancers [ 163 ]. In vitro studies have revealed that changes in gut and skin microbiome were associated with the progression of melanomas [ 164 ].…”