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Session: ePoster: Other Neoplasia and Endoscopy 3 (Sun350)

EP570 - Increased Rates of HPV-Related Cancers in Patients with Ulcerative Colitis and Crohn's Disease

Sunday, May 11, 2025
4:28 PM – 4:33 PM PT
Location: Monitor 4, Sails Pavilion, Upper Level

    Senior Author(s)

  • LM

    Lillias Maguire, MD (she/her/hers)

    Assistant Professor of Surgery
    University of Pennsylvania
    Philadelphia, Pennsylvania, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no relevant relationships with ineligible companies.

    • ePoster Presenter(s)

  • Razmik Ghukasyan, MD, MBA

    Fellow Physician
    University of Pennsylvania
    Chesterbrook, PA, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • Jeffrey L. Roberson, MD

    Resident
    The Hospital of the University of Pennsylvania
    The Hospital of the University of Pennsylvania
    Philadelphia, Pennsylvania, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

All of the relevant financial relationships listed below have been mitigated.
Lillias Maguire, MD: This individual has no relevant relationships with ineligible companies.
Razmik Ghukasyan, MD, MBA: This individual has no financial relationships with ineligible companies.
Jeffrey L. Roberson, MD: This individual has no financial relationships with ineligible companies.
Image or Table (Do Not add text here):

Purpose/Background: Crohn’s Disease (CD) and Ulcerative Colitis (UC) are associated with increased incidence of small bowel and colorectal adenocarcinoma. More limited data also suggest that CD and UC may be associated with development of human papilloma virus (HPV)-related cancers (HPV-Cs) such as anal cancer, cervical cancer, multiple subtypes oral cancer, vulvovaginal cancer, and penile cancer. Veterans are at elevated risk for the development of HPV-Cs due to increased exposure to risk factors for these malignancies including smoking and HIV. We hypothesized that Veterans would provide a high-risk population in which to study the impact of UC and CD on development of HPV-Cs.

Methods/Interventions: We queried the Veterans Health Administration Central Data Warehouse (CDW) for patients with diagnoses of UC or CD and/or HPV-Cs between 2015 and 2021. The CDW is a central resource collating extensive health, lifestyle, medication, and surgical data for the over 9 million Veterans receiving care from the Veterans Health Administration (VHA). ICD10 diagnostic codes were used to identify patients with UC and CD and HPV-Cs. Due to small numbers, vulvovaginal cancers and multiple subtypes of oral cancer were grouped together.

Results/Outcomes: We identified 125,186 patients with a diagnostic code for UC or CD. Consistent with the VHA population, patients were overwhelmingly male. Among these patients, there were 988 apparent cases of HPV-C’s as identified by patients having two or more encounters with these diagnostic codes. Oropharyngeal cancer was the most common with 513 cases, followed by anal cancer with 310 cases. Unsurprisingly, cases of cervical/vulvovaginal cancer were low (n=47) in this overwhelmingly male population. Rates of HPV-Cs overall and anal cancer in particular were substantially higher in UC/CD patients than previously reported in Veterans as a whole.

Conclusion/Discussion: We have identified a potential signal of increased rates of HPV-Cs in Veterans with UC and CD. There is a plausible biological link of immunosuppression. This has translational relevance for increased screening and vaccination of these patients. Future directions include further sub-phenotyping UC/CD patients based on immunosuppressive and biologic medications, HIV status, and smoking.