{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T18:56:01Z","timestamp":1789152961266,"version":"build-2803163510"},"reference-count":39,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,10,4]],"date-time":"2021-10-04T00:00:00Z","timestamp":1633305600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["U24 CA55727"],"award-info":[{"award-number":["U24 CA55727"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2022,1,15]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Human papillomavirus (HPV)\u2010associated subsequent malignant neoplasms (SMN<jats:sub>HPV<\/jats:sub>) in childhood cancer survivors are poorly understood.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The cumulative risk of SMN<jats:sub>HPV<\/jats:sub> was assessed among 24,363 Childhood Cancer Survivor Study participants. Standardized incidence ratios (SIRs) and absolute excess risk were calculated using age\u2010matched, sex\u2010matched, and calendar year rates from the Surveillance, Epidemiology, and End Results program. Poisson regression models identified SMN<jats:sub>HPV<\/jats:sub> risk factors, evaluating relative SIRs (rSIR) and 95% confidence intervals (95% CIs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 46 survivors developed an SMN<jats:sub>HPV<\/jats:sub> (median age, 31 years [range, 10\u201056 years]; median time from primary cancer, 21 years [range, 9\u201035 years]). SMN<jats:sub>HPV<\/jats:sub> sites included oropharynx (N = 44), anorectum (N = 6), uterine cervix (N = 2), and vulva (N = 2). The 33\u2010year cumulative incidence was 0.3% (95% CI, 0.2%\u20100.4%), and the SIR was nearly 3\u2010fold that of the general population (SIR, 2.86; 95% CI, 2.05\u20104.00). Female survivors were not at increased risk of cervical or vulvar cancers compared with the general population. All survivors had an elevated risk of oropharyngeal SMN<jats:sub>HPV<\/jats:sub> (males: SIR, 4.06; 95% CI, 2.37\u20106.97; females: SIR, 8.44; 95% CI 4.88\u201014.61) and anorectal SMN<jats:sub>HPV<\/jats:sub> (males: SIR, 13.56; 95% CI, 5.09\u201036.13; females: SIR, 9.15; 95% CI, 2.29\u201036.61). Males (vs females: rSIR, 1.99; 95% CI, 1.00\u20103.94); head, neck, and pelvic radiotherapy doses &gt;3000 centigray (vs none: rSIR, 2.35; 95% CI, 1.11\u20104.97); and cisplatin\u2010equivalent doses &gt;400 mg\/m<jats:sup>2<\/jats:sup> (vs none: rSIR, 4.51; 95% CI, 1.78\u201011.43) were associated with increased SMN<jats:sub>HPV<\/jats:sub> SIRs in multivariable analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Childhood cancer survivors are at increased risk for SMN in sites susceptible to HPV\u2010associated malignancies. Further research examining HPV in the etiology of SMN and the promotion of HPV vaccination and surveillance guidelines for SMN<jats:sub>HPV<\/jats:sub> in cancer survivors is warranted.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.33922","type":"journal-article","created":{"date-parts":[[2021,10,7]],"date-time":"2021-10-07T17:24:43Z","timestamp":1633627483000},"page":"373-382","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Subsequent malignant neoplasms in the Childhood Cancer Survivor Study: Occurrence of cancer types in which human papillomavirus is an established etiologic risk factor"],"prefix":"10.1002","volume":"128","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9394-6206","authenticated-orcid":false,"given":"Tara O.","family":"Henderson","sequence":"first","affiliation":[{"name":"Department of Pediatrics University of Chicago Comer Children's Hospital Chicago 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Oncology, Blood and Marrow Transplantation University of Minnesota Minneapolis Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A.","family":"Arnold","sequence":"additional","affiliation":[{"name":"Department of Pathology Children's Hospital of Colorado University of Colorado Denver Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam R.","family":"Conces","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Nationwide Children's Hospital Columbus Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca M.","family":"Howell","sequence":"additional","affiliation":[{"name":"Radiation Physics The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie L.","family":"Robison","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Cancer Control St Jude Children's 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