Risk of second primary cancer after a first potentially-human papillomavirus-related cancer: A population-based study

• Published in: Preventive medicine 2016-09, Vol.90, p.52-58
• Main Authors: Neumann, Florent, Jégu, Jérémie, Mougin, Christiane, Prétet, Jean-Luc, Guizard, Anne-Valérie, Lapôtre-Ledoux, Bénédicte, Bara, Simona, Bouvier, Véronique, Colonna, Marc, Troussard, Xavier, Trétarre, Brigitte, Grosclaude, Pascale, Velten, Michel, Woronoff, Anne-Sophie
• Format: Article
• Language: English
• Subjects: Female; France; Head and Neck Neoplasms - epidemiology; Human papillomavirus; Humans; Incidence; Internal Medicine; Life Sciences; Neoplasms, second primary; Neoplasms, Second Primary - epidemiology; Papillomaviridae; Papillomaviridae - isolation & purification; Papillomavirus Infections - complications; Population Surveillance - methods; Registries; Retrospective Studies; Risk assessment; Risk Factors; Urogenital Neoplasms - epidemiology
• ISSN: 0091-7435; 1096-0260
• DOI: 10.1016/j.ypmed.2016.06.041

Abstract Human papillomaviruses (HPV) are involved in the development of anogenital and head and neck cancers. The purpose of this study was to assess the risk of developing a second primary cancer (SPC) after a first potentially-HPV-related cancer, and to analyze the sites where SPCs most frequently occurred in these patients. All patients with a first cancer diagnosed between 1989 and 2004, as recorded by 10 French cancer registries, were followed up until December 31, 2007. Only invasive potentially-HPV-related cancers (namely, cervical, vagina, vulva, anal canal, penile, oropharynx, tongue and tonsil) were included. Standardized Incidence Ratios (SIRs) were calculated to assess the risk of SPC. A multivariate Poisson regression model was used to model SIRs separately by gender, adjusted for the characteristics of the first cancer. 10,127 patients presented a first potentially-HPV-related cancer. The overall SIR was 2.48 (95% CI , 2.34 – 2.63). The SIR was 3.59 (95% CI, 3.33 – 3.86) and 1.61 (95% CI, 1.46 – 1.78) in men and women respectively. The relative risk of potentially-HPV-related SPC was high among these patients (SIR = 13.74; 95% CI, 8.80 – 20.45 and 6.78; 95% CI, 4.61 – 9.63 for men and women, respectively). Women diagnosed in the most recent period (2000 – 2004) showed a 40% increase of their relative risk of SPC as compared with women diagnosed between 1989 and 1994 (ratio of SIRs = 1.40; 95% CI, 1.06 – 1.85). HPV cancer survivors face an increased risk of SPC, especially second cancer. Clinicians may consider this increased risk of developing HPV-related SPC during follow-up to improve subsequent cancer prevention in these patients.