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HPV-related cancers after solid organ transplantation in the United States.
Am J Transplant 2013; 13(12):3202-9AJ

Abstract

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.

Authors+Show Affiliations

Program in Epidemiology, Fred Hutchinson Cancer Research Center, Seattle, WA; Department of Epidemiology, University of Washington, Seattle, WA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Intramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

24119294

Citation

Madeleine, M M., et al. "HPV-related Cancers After Solid Organ Transplantation in the United States." American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons, vol. 13, no. 12, 2013, pp. 3202-9.
Madeleine MM, Finch JL, Lynch CF, et al. HPV-related cancers after solid organ transplantation in the United States. Am J Transplant. 2013;13(12):3202-9.
Madeleine, M. M., Finch, J. L., Lynch, C. F., Goodman, M. T., & Engels, E. A. (2013). HPV-related cancers after solid organ transplantation in the United States. American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 13(12), pp. 3202-9. doi:10.1111/ajt.12472.
Madeleine MM, et al. HPV-related Cancers After Solid Organ Transplantation in the United States. Am J Transplant. 2013;13(12):3202-9. PubMed PMID: 24119294.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - HPV-related cancers after solid organ transplantation in the United States. AU - Madeleine,M M, AU - Finch,J L, AU - Lynch,C F, AU - Goodman,M T, AU - Engels,E A, Y1 - 2013/10/01/ PY - 2013/02/26/received PY - 2013/08/12/revised PY - 2013/08/12/accepted PY - 2013/10/15/entrez PY - 2013/10/15/pubmed PY - 2014/7/26/medline KW - HPV-related cancer KW - Transplant Cancer Match Study KW - immunosuppression KW - organ transplant cohort SP - 3202 EP - 9 JF - American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons JO - Am. J. Transplant. VL - 13 IS - 12 N2 - 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. SN - 1600-6143 UR - https://www.unboundmedicine.com/medline/citation/24119294/HPV_related_cancers_after_solid_organ_transplantation_in_the_United_States_ L2 - https://doi.org/10.1111/ajt.12472 DB - PRIME DP - Unbound Medicine ER -