HPV-related cancers after solid organ transplantation in the United States

M M Madeleine; J L Finch; C F Lynch; M T Goodman; E A Engels

doi:10.1111/ajt.12472

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HPV-related cancers after solid organ transplantation in the United States

Journal article

Open access

Peer reviewed

HPV-related cancers after solid organ transplantation in the United States

M M Madeleine, J L Finch, C F Lynch, M T Goodman and E A Engels

American journal of transplantation, Vol.13(12), pp.3202-3209

12/2013

DOI: 10.1111/ajt.12472

PMCID: PMC4049182

PMID: 24119294

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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.

United States - epidemiology

Humans

Middle Aged

Uterine Cervical Neoplasms - epidemiology

Anus Neoplasms - virology

Male

Incidence

Penile Neoplasms - epidemiology

Young Adult

Vulvar Neoplasms - complications

Immunosuppression - adverse effects

Adult

Female

Papillomavirus Infections - virology

Registries

Anus Neoplasms - epidemiology

Penile Neoplasms - virology

Papillomavirus Infections - complications

Penile Neoplasms - complications

Papillomavirus Infections - epidemiology

Vulvar Neoplasms - virology

Oropharyngeal Neoplasms - virology

Tacrolimus - adverse effects

Oropharyngeal Neoplasms - complications

Oropharyngeal Neoplasms - epidemiology

Anus Neoplasms - complications

Organ Transplantation - adverse effects

Uterine Cervical Neoplasms - complications

Adolescent

Vulvar Neoplasms - epidemiology

Uterine Cervical Neoplasms - virology

Cohort Studies

Details

Title: Subtitle: HPV-related cancers after solid organ transplantation in the United States
Creators: M M Madeleine - Program in Epidemiology, Fred Hutchinson Cancer Research Center, Seattle, WA; Department of Epidemiology, University of Washington, Seattle, WA
J L Finch
C F Lynch
M T Goodman
E A Engels
Resource Type: Journal article
Publication Details: American journal of transplantation, Vol.13(12), pp.3202-3209
DOI: 10.1111/ajt.12472
PMID: 24119294
PMCID: PMC4049182
NLM abbreviation: Am J Transplant
ISSN: 1600-6143
eISSN: 1600-6143
Publisher: United States
Grant note: N01PC35142 / NCI NIH HHS 5U58DP000824-04 / NCCDPHP CDC HHS U58DP000832 / NCCDPHP CDC HHS HHSN261201000024C / NCI NIH HHS U58 DP000807 / NCCDPHP CDC HHS U58 DP000824 / NCCDPHP CDC HHS HHSN261201000036C / NCI NIH HHS N01PC54405 / NCI NIH HHS 5U58DP000812-03 / NCCDPHP CDC HHS U58 DP000817 / NCCDPHP CDC HHS N01PC35137 / NCI NIH HHS 5U58/DP000808-05 / NCCDPHP CDC HHS U58 DP000812 / NCCDPHP CDC HHS 5U58DP000817-05 / NCCDPHP CDC HHS Intramural NIH HHS U58 DP000832 / NCCDPHP CDC HHS HHSN261201000035C / NCI NIH HHS HSN261201000032C / PHS HHS U58 DP000805 / NCCDPHP CDC HHS 5658DP000805-04 / NCCDPHP CDC HHS N01-PC-35143 / NCI NIH HHS 1U58 DP000807-01 / NCCDPHP CDC HHS U58 DP000848 / NCCDPHP CDC HHS N01-PC-35137 / NCI NIH HHS U58 DP000808 / NCCDPHP CDC HHS HHSN261201000034C / NCI NIH HHS P01 CA042792 / NCI NIH HHS U58DP0038789 / NCCDPHP CDC HHS N01-PC-54405 / NCI NIH HHS N01-PC-35142 / NCI NIH HHS N01PC35139 / NCI NIH HHS P30 CA086862 / NCI NIH HHS HHSN261201000037C / NCI NIH HHS HHSN261201000027C / NCI NIH HHS N01PC35143 / NCI NIH HHS N01-PC-35139 / NCI NIH HHS HHSN261201000026C / NCI NIH HHS U58 DP000848-04 / NCCDPHP CDC HHS HHSN261201000035I / NCI NIH HHS
Language: English
Date published: 12/2013
Academic Unit: Epidemiology
Record Identifier: 9983995051402771

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