A team of researchers at Huntsman Cancer Institute and the University of Utah (the U) found that human papillomavirus-related cancer diagnoses are more common in adolescent and young adults (AYAs) who have previously had cancer. The team is led by Anne Kirchhoff, PhD, MPH, investigator in the Cancer Control and Population Sciences Research Program and associate professor of pediatrics at the U.

Human papillomavirus (HPV) is a very common infection spread through sexual contact. According to the Intermountain West HPV Coalition, most people will be infected with HPV some time in their life after becoming sexually active. There are about 40 types of HPV that are transmitted sexually; a portion of these cause cancer. The immune system typically controls the virus but some types of the HPV strains, called high-risk, can last a long time and lead to cancer. For young adults who have previously undergone cancer treatment, their immune system may be even less able to control the infection.

Vaccination is the best way to prevent cancer caused by HPV, which some AYA patients are foregoing.

Kirchhoff and her team investigated whether these young adult cancer survivors may be more likely to have a HPV-related cancer than the general population. Using national data from the Surveillance, Epidemiology, and End Results (SEER-9) registries, Kirchhoff and her team identified a trend of secondary cancer diagnoses related to HPV infection. According to the National Cancer Institute, the SEER program is used to support cancer surveillance through population data. They used this data from the program to look at the risk factors associated with those infected with HPV.

Compared to the general population, researchers found that AYA survivors had a 70% increased risk for HPV cancers. Survivors experienced an even higher risk (117%) of developing oropharyngeal cancers, cancer of the mouth and throat. Hispanic AYA survivors were at a higher risk of developing cervical HPV-related cancers than other AYA survivors and the general population.

Certain HPV-related cancers, including oropharyngeal cancers, are increasing in the general population. What we are seeing in our AYA cancer patients mimics this. However, AYA patients have an elevated risk beyond the general population."

Anne Kirchhoff, PhD, MPH, Investigator, Cancer Control and Population Sciences Research Program

With this discovery, Kirchhoff hopes to identify ways to support AYA patients after their original cancer diagnosis and treatment.

"My work involves understanding the healthcare needs of young patients after they are done with treatment," says Kirchhoff. "The HPV vaccine is a way to protect yourself from cancer. While data shows that HPV vaccination rates have improved dramatically in Utah, we are still seeing a low number of high-risk populations, like AYA patients, using the HPV vaccine as a cancer prevention tool." Stressing the importance of this cancer prevention vaccine is critical.

Most primary care providers have access to HPV vaccines, but some may not be recommending it to someone with a history of cancer, according to Kirchhoff. Patients may not feel that they need the HPV vaccine.

"One of the most impactful things we can do is educate the public and spark important conversations between patients and their providers. Younger patients are at the age where the immune response to the HPV vaccine is going to the best," says Kirchhoff. "We can prevent cancer caused by HPV."

AYA patient navigators, available at Huntsman Cancer Institute, can help guide and support patients during and after their cancer treatment.