Author(s)
Isabelle L.A. Borgstein, MD
Lennart B. Van Rijssen, Frederik G. Dikkers
Affiliation(s)
Amsterdam UMC, University of Amsterdam;
Abstract:
Objective: Well-known risk factors for the development of juvenile and adult-onset recurrent respiratory papillomatosis (RRP) are human papillomavirus (HPV) types 6 and 11. However, other risk factors may contribute to its development. No review on this subject exists to date. The aim of this review is to identify risk factors for the development of RRP in children and adults and to help counsel patients.
Methods: A literature search was conducted in PubMed and Embase for articles published between 2000 and 2021. Studies reporting clinical risk factors for the development of RRP were included.
Results: After screening 1,395 studies, nine studies involving 468 RRP cases were included. The three risk factors that were investigated most frequently were HPV type, laryngopharyngeal reflux, and tobacco exposure (in five, three, and three studies respectively). The three risk factors that were studied in the highest number of patients were HPV type in 300, type of delivery (caesarean versus vaginal) in 105, and tobacco exposure in 86 patients. The three risk factors that were significantly associated with a higher risk of development of RRP in the greatest number of patients were vaginal delivery duration of at least ten hours among women with genital warts, maternal history of genital warts, and male gender. None of the determined risk factors were statistically significant in more than one study.
Conclusion: This systematic review identified clinical risk factors for the development of RRP. These findings should aid patient counselling and shared decision-making.