New England Section of the American Urological Association

Back to 2019 Abstracts


Re-Examining An Old Trend: The Association of Human Papillomavirus and Bladder Cancer
Lael Reinstatler, MD, MPH1, Kevin Shee, PhD1, Krisitian Stensland, MD, MPH2, Lawrence Dagrosa, MD1, John Seigne, MB1, Einar F. Sverrisson, MD1
1Dartmouth Hitchcock Medical Center, Lebanon, NH, 2Lahey Clinic, Burlington, MA

BACKGROUND: Exposure to the Human Papilloma Virus (HPV) is a recognized carcinogenic factor. Previous studies have shown a possible association between HPV and bladder cancer; however, associations with HPV serology have not been reported. In this study, we assessed the correlation between HPV positive serology and bladder cancer.
METHODS: Using NHANES, a large nationally-representative population-based survey, we gathered clinical and demographic data on all patients with a diagnosis of bladder cancer from 2007-2010 and analyzed their HPV serology status. We assessed the association of positive serologic results for HPV18, HPV16, HPV11, and HPV6 on the rates of bladder cancer diagnosis.
RESULTS: Over the four-year period there was a weighted population of 298,120,000 Americans. The prevalence of HPV positive serology was as follows: HPV18 - 5.5%, HPV16 - 13.2%, HPV11 - 6.4%, HPV6 - 17.4%. There were 443,948 bladder cancer cases. Among cases compared to controls there was a higher prevalence of male gender (80% vs 53%, p = 0.0056), Caucasian race (93% vs 66%, p = 0.001), and HPV6 positive serology (18.1% vs 17.6%, p = 0.0005). There was no difference among the other three HPV types. On logistic regression controlling for race, gender, and smoking status, increasing body weight (OR 1.01, p <0.0001) and HPV6 positivity (OR 1.9, p<0.0001) were associated with increased odds of bladder cancer diagnosis while increasing age (OR 0.89, p<0.0001) and HPV11 positivity (OR 0.23, p<0.0001) were protective.
CONCLUSIONS: Prior research has shown that there is likely a relationship between HPV and bladder cancer, but this relationship has previously been incompletely defined. In this large, nationally representative database, we describe a significant association of HPV6 positive serology with a diagnosis of bladder cancer and, similar to prior studies, we demonstrate that this association is likely associated with younger age at diagnosis. This finding is striking and might affect future investigation into the pathophysiologic basis of this relationship.


Back to 2019 Abstracts