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Scientific Oral Presentations

Laryngology/Broncho-Esophagology

Session: Scientific Oral Presentation 4 - Laryngology/Broncho-Esophagology

Long-Term Impact of HPV Vaccination on Pediatric Recurrent Respiratory Papillomatosis Incidence and Management

Tuesday, October 14, 2025

10:12 AM - 10:18 AM EDT

Location: 120

Disclosure(s):

Alexandra F. Corbin, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Murilo W. de Santana Hager, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Recurrent respiratory papillomatosis (RRP) imposes significant burdens on families and healthcare systems due to the need for frequent interventions and ongoing care. The introduction of the Human Papillomavirus (HPV) vaccine in 2006 has shown promise in reducing RRP incidence and associated healthcare demands. This study analyzed 19-year trends in RRP incidence and treatment alongside increasing vaccine adoption.

Methods: This retrospective cohort study utilized the TriNetX United States (US) Collaborative Network to identify pediatric RRP cases (≤18 years) diagnosed between January 1, 2006, to December 31, 2024. Key outcomes included trends in RRP incidence, HPV vaccination rates, and RRP treatment modalities (localized excision, tracheotomy, bevacizumab, cidofovir), identified via ICD-10, CPT, RxNorm, and HCPCS codes.

Results: 1,854 pediatric RRP patients were included (mean age at diagnosis 7.9 years, SD=5.7), with 931 (50.2%) male, 914 (49.3%) female, and 9 (0.5%) of unknown sex. RRP incidence declined by 65.2% over the 19-year study period, from 3.1 per 100,000 in 2006 to 1.1 per 100,000 in 2024 (P <.001). Concurrently, HPV vaccination rates in the US rose by 1,448.1% (P <.001). A strong negative correlation was observed between annual RRP incidence and HPV vaccination rates (R(17)=-0.89, P<.001).

Treatment patterns for RRP evolved over time. Bevacizumab use increased from 0.0% in 2009 (its first reported use for RRP) to 1.5% in 2024 (P <.001) and cidofovir use rose from 0.0% in 2006 to 0.7% in 2024 (P <.001). In contrast, localized excision rates remained stable, from 6.8% in 2006 to 7.5% in 2024 (P=.702), as did tracheotomy rates, from 1.9% in 2006 to 1.7% in 2024 (P=.832).

Conclusions: Rising HPV vaccination rates are associated with a significant decline in pediatric RRP incidence. Surgical excision remains the primary treatment, with limited adoption of emerging pharmacologic therapies, such as bevacizumab and cidofovir, indicating minimal change in overall management strategies.

Presenting Author(s)

Alexandra F. Corbin, BS

Medical Student
Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo
Buffalo, NY, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

GV

Gaayathri Varavenkataraman, MA

Research Assistant
Department of Otolaryngology, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo
East Amherst, New York, United States

Disclosure information not submitted.
MS

Michael Sturniolo, BS

Medical Student
Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, United States

Disclosure information not submitted.
Beatrice R. Bacon, BS

Medical Student
Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo
Basom, New York, United States

Disclosure information not submitted.
Murilo W. de Santana Hager, BS

Medical Student
Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo
Buffalo, New York, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Senior Author(s)

MC

Michele M. Carr, DDS MD PhD

Professor
Department of Otolaryngology, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo
Williamsville, New York, United States

Disclosure information not submitted.