Incidence and risk factors for HPV-associated cancers in women with end-stage renal disease.

Autor:	Han J; Department of Medicine, Medical College of Georgia, Augusta, Georgia, USA., Waller JL; Department of Population Health Sciences, Medical College of Georgia, Augusta, Georgia, USA., Colombo RE; Department of Medicine, Medical College of Georgia, Augusta, Georgia, USA., Spearman V; Department of Medicine, Medical College of Georgia, Augusta, Georgia, USA., Young L; Department of Medicine, Medical College of Georgia, Augusta, Georgia, USA., Kheda MF; Department of Medicine, Medical College of Georgia, Augusta, Georgia, USA., Mohammed A; Department of Medicine, Medical College of Georgia, Augusta, Georgia, USA., Bollag WB; Department of Dermatology, Medical College of Georgia, Augusta, Georgia, USA., Nahman NS; Department of Medicine, Medical College of Georgia, Augusta, Georgia, USA., Baer SL; Department of Medicine, Medical College of Georgia, Augusta, Georgia, USA stephanie.baer@va.gov.; Infection Control and Epidemiology, Augusta VA Medical Center, Augusta, Georgia, USA.
Jazyk:	angličtina
Zdroj:	Journal of investigative medicine : the official publication of the American Federation for Clinical Research [J Investig Med] 2020 Jun; Vol. 68 (5), pp. 1002-1010. Date of Electronic Publication: 2020 Jun 04.
DOI:	10.1136/jim-2019-001262
Abstrakt:	Human papillomavirus (HPV) causes the majority of cervical, anal/rectal, and oropharyngeal cancers in women. End-stage renal disease (ESRD) is also associated with an increased risk of malignancy, but the incidence of and risk factors for HPV-associated cancers in US dialysis patients are not defined. We queried the US Renal Data System for women with HPV-associated cancers and assessed for incidence of cancer diagnosis and association of risk factors. From 2005 to 2011, a total of 1032 female patients with ESRD had 1040 HPV-associated cancer diagnoses. Patients had a mean age of 65 years, were mostly white (63%), and on hemodialysis (92%). Cervical cancer (54%) was the most common, followed by anal/rectal (34%), and oropharyngeal (12%). The incidence of HPV-associated cancers in patients with ESRD increased yearly, with up to a 16-fold increased incidence compared with the general population. Major risk factors associated with the development of any HPV-associated cancer included smoking (adjusted relative risk=1.89), alcohol use (1.87), HIV (2.21), and herpes infection (2.02). Smoking, HIV, and herpes infection were prominent risk factors for cervical cancer. The incidence of HPV-associated cancers in women with ESRD is rising annually and is overall higher than in women of the general population. Tobacco use is a universal risk factor. For cervical cancer, the presence of HIV and herpes are important comorbidities. Recognizing risk factors associated with these cancers may improve diagnosis and facilitate survival. The role of HPV vaccination in at-risk dialysis patients remains to be defined but warrants further study. Competing Interests: Competing interests: None declared. (© American Federation for Medical Research 2020. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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