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Thomas Flaig, MD


Is There a Link Between Bladder Cancer and Human Papillomavirus?

By: Celeste L. Dixon
Posted: Wednesday, February 16, 2022

The pursuit of answers seems to have resulted in more questions when it comes to ascertaining the possible association of human papillomavirus (HPV) with bladder cancer. As Alireza Khatami, MD, MSc, of Iran University of Medical Sciences in Tehran, and colleagues described in Infectious Agents and Cancer, older analyses suggest a significant association, but newer work is needed to evaluate data from the past decade to refine this conclusion. Consequently, they undertook a meta-analysis of studies—all published in English between January 2011 and March 2021—that included 27 data sets and a total of 2,954 patients with bladder cancer from 18 countries.

Overall, they found no significant association between HPV and bladder cancer (odds ratio = 2.077). However, HPV’s pooled prevalence was relatively high at 14.3%, and “given [that] significant prevalence…, it seems that more studies with [a] case-control design are needed to elucidate this association,” wrote the authors.

According to the team’s subgroup analysis by continent, the highest association between HPV and bladder cancer risk was in Asia (odds ratio = 6.289). That analysis also showed the maximum and minimum prevalences of HPV infection among patients with bladder cancer were found in Africa and Oceania, respectively (51.2% vs. 2.2%).

Further subgroup analysis based on HPV types indicated that high-risk types tended to be associated with a higher prevalence (16.2%) than low-risk types (4.8%) among patients with bladder cancer overall. Regarding high-risk genotypes, the prevalence of HPV 18 did not significantly differ from that of HPV 16 (10.0% vs. 10.2%).

Dr. Khatami and co-investigators agree with the results of previous research indicating that the association between HPV and bladder cancer in Asiacould be related to genetics, ethnic, lifestyle, and even sexual behaviors as well as other unknown risk factors.” And, they continued, “it should be noted that the lack of association in other regions, especially Africa, is probably due to the small number of studies and the sample size.”

Disclosure: The study authors reported no conflicts of interest.

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