EARLY LIFE-COURSE PATTERNS OF REGISTRY-DEFINED SUBSEQUENT CANCERS AFTER HPV-RELATED MALIGNANCIES IN A U.S. POPULATION-BASED COHORT

Sep 22, 2026

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Subsequent primary malignancies after human papillomavirus (HPV)–related cancers are a major survivorship concern, yet sociodemographic and clinical predictors remain insufficiently characterized in U.S. population-based cohorts of children, adolescents, and young adults. A retrospective SEER-based analysis evaluated 1,326 individuals to identify registry-defined subsequent cancers using SEER multiple primary rules. Multivariable logistic regression assessed sex, age group, area-level socioeconomic status, persistent poverty status, and primary cancer site.

LanguageEnglish

CategoryHealthcare

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Pages10

Reading Time25 min

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Abstract

Background

Methods

Results

Conclusions

Introduction

medRxiv preprint doi: [https://doi.org/10.64898/2026.01.14.26344109](https://doi.org/10.64898/2026.01.14.26344109); this version posted January 16, 2026. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-NC-ND 4.0 International license . EARLY LIFE-COURSE PATTERNS OF REGISTRY-DEFINED SUBSEQUENT CANCERS AFTER HPV-RELATED MALIGNANCIES IN A U.S. POPULATIONBASED COHORT Jennifer M. Torres Del Valle, PhD, MPH, MA¹, Claudia P. Amaya-Ardila, EdD¹, MPH; Souhail M. Malavé-Rivera, PhD, MSc ¹ ¹ Graduate School of Public Health & Post Doctoral in Clinical and Translational Research Program, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico Corresponding Author Jennifer M. Torres Del Valle, PhD, MPH, MA Graduate School of Public Health University of Puerto Rico, Medical Sciences Campus San Juan, Puerto Rico [Email: j](Email: jennifer.torres@upr.edu)[ennifer.torres@upr.edu](Email: jennifer.torres@upr.edu) Abstract Background Subsequent primary malignancies following human papillomavirus (HPV)–related cancers represent an important survivorship concern. However, evidence remains limited regarding sociodemographic and clinical factors associated with registry-defined subsequent cancers among children, adolescents, and young adults in U.S. population-based cohorts. Methods We conducted a retrospective population-based analysis of 1,326 individuals diagnosed with HPV-related cancers using Surveillance, Epidemiology, and End Results (SEER) data. Registrydefined subsequent cancer was operationalized as the occurrence of additional primary HPVrelated malignancies according to SEER multiple primary rules. Multivariable logistic regression models estimated associations with sex, age group, area-level socioeconomic status (Yost Index quintiles), persistent poverty census tract status, and primary cancer site. Sex-stratified analyses by cancer site were performed. Results Registry-defined subsequent cancers were significantly associated with female sex and young adult age (20–29 years) . Females had higher odds of subsequent cancer compared with males (OR = 1.06, 95% CI: 1.03–1.10), and individuals aged 20–29 years had higher odds than those aged 0–9 years (OR = 1.10, 95% CI: 1.05–1.16). Associations persisted after adjustment for socioeconomic indicators. No significant associations were observed with Yost Index quintiles or persistent poverty. Sex-stratified analyses showed higher odds of subsequent cancer for anal cancer among males and vulvar cancer among females relative to oropharyngeal cancer. 1 NOTE: This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice. medRxiv preprint doi: [https://doi.org/10.64898/2026.01.14.26344109](https://doi.org/10.64898/2026.01.14.26344109); this version posted January 16, 2026. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-NC-ND 4.0 International license . Conclusions Sex and age are key determinants of registry-defined subsequent cancers following HPV-related malignancies, independent of area-level socioeconomic context. These findings support age-and sex-specific survivorship surveillance strategies across early life-course stages. Key words: Human papillomavirus; HPV-related cancers; Subsequent primary cancer; Adolescent and young adult cancer; SEER Introduction Human papillomavirus (HPV)–related cancers continue to pose a substantial burden in the United States despite advances in primary prevention, including vaccination. HPV isetiologically linked to malignancies across multiple anatomic sites, including the cervix, anus, vulva, vagina, penis

FAQs

What was the main objective of the study?

To identify sociodemographic and clinical factors associated with registry-defined subsequent cancers after HPV-related malignancies in U.S. children, adolescents, and young adults.

How were registry-defined subsequent cancers measured?

They were defined as additional primary HPV-related malignancies using Surveillance, Epidemiology, and End Results (SEER) multiple primary rules.

Which factors were significantly associated with subsequent cancers?

Female sex and young adult age (20–29 years) showed higher odds of subsequent cancer, and these associations remained after adjustment for socioeconomic indicators.

Sep 22, 2026

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