Biography

Dr. Kreimer received a Ph.D. in Infectious Disease Epidemiology from the Johns Hopkins Bloomberg School of Public Health in 2003. She conducted post-doctoral research at the International Agency for Research on Cancer in Lyon, France, working on the largest case-control study to date on human papillomavirus (HPV) and oral cancer, as well as the National Cancer Institute, working on multiple large-scale studies of HPV and cancers of the head and neck, esophagus, and cervix. She is a newly appointed investigator to the Infections and Immunoepidemiology Branch. In that capacity, she continues to focus her research on HPV and cancers at multiple sites, including the upper aerodigestive tract and the cervix.

Research Interests

• Evaluating the role of HPV in cancers of the head and neck and other extra-cervical sites
• Describing the natural history and epidemiology of HPV infections at extra-cervical sites, particularly the oral region
• Determining the potential impact of HPV vaccination on extra-cervical infections
• Studying the long term impact of HPV vaccination

Human papillomaviruses are one of the principal infectious agents known to cause cancers in humans; it is estimated that approximately 5% of cancers worldwide are attributable to HPV infection. While it is well established that HPV is a necessary cause of cervical cancer, studies suggest HPV may also be a causative agent in a subset of oropharyngeal, oral, skin, penile, vulvar, vaginal, and anal cancers. Dr. Kreimer’s research focuses on the evaluation of the epidemiology and carcinogenicity of HPV at anatomic sites beyond the cervix. To that end, Dr. Kreimer conducts studies to evaluate the natural history of HPV infections at non-cervical sites and to assess the prospective association between HPV infection and risk of cancer at these sites.

With the advent and subsequent success of the HPV vaccine, a unique prevention opportunity has arisen for HPV-associated cancers, especially important for those with no prevention alternatives such as screening. While likely that the HPV vaccine will protect against extra-cervical infections akin to the near complete prophylactic efficacy observed for cervical and vulvar infections, a direct evaluation of vaccine efficacy at these sites is lacking. To that end, Dr. Kreimer is actively involved in expanding the 7,500 women NCI-sponsored, community-based HPV Vaccine Trial (CVT) in Costa Rica to include the evaluation of efficacy at anatomic sites other than the cervix. In addition, Dr. Kreimer is responsible for the evaluation of the long term impact of HPV vaccination within NCI’s CVT trial.

Keywords

Human papillomavirus (HPV), HPV vaccination, HPV natural history, head and neck cancer, cervical cancer

Selected Publications

• Kreimer AR. Invited editorial on the publication: Oral sexual behaviors associated with prevalent oral human papillomavirus (HPV) infection by D'Souza et al. Journal of Infectious Diseases. In press.
• Castle PE, Kreimer AR, Wacholder S, Solomon D, Wheeler C, Koutsky L, Rydzak G, Buckman DW, Graubard B, Schiffman M. The Influence of Loop Electrosurgical Excision Procedure on the Acquisition of HPV. Clinical Infectious Diseases. In press.
• Miller JH and Kramer BS* (*shared first author position), Kreimer AR, Prorok PC, Xu JL, Baker SG, Fagerstrom R, Berg CD, Gohagan JK and The Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial Project Team. Cumulative false-positives (FP) in the Prostate, Lung, Colorectal, Ovarian (PLCO) Cancer Screening Trial. Annals of Family Medicine . In press
• D’Souza G, Kreimer AR, Viscidi R, Pawlita M, Fakhry C, Koch W, Westra W, Gillison ML. Oropharyngeal cancer attributable to human papillomavirus 16 infection. NEJM. 2007;356:1944-56.
• Kreimer AR, Katki H, Schiffman M, Wheeler C, and Castle P for the ASCUS-LSIL Triage Study (ALTS) Group. Determinants of HPV persistence following LEEP treatment for cervical intraepithelial neoplasia grade 2 or 3. Cancer Epidemiol Biomarkers Prev. 2007; 16(1):11-6.
• Kreimer AR, Guido R, Solomon D, Schiffman M, Wacholder S, Jeronimo J, Wheeler C, and Castle P for the ASCUS-LSIL Triage Study (ALTS) Group. HPV testing following loop electrosurgical excision procedure (LEEP) identifies women at risk for post-treatment cervical intraepithelial neoplasia grade 2 or 3 disease. Cancer Epidemiol Biomarkers Prev . 2006; 15(5):908-14.
• Kreimer AR, Randi G, Herrero R, Castellsagué X, La Vecchia C, Franceschi S for the IARC Multicenter Oral Cancer Study Group. Fruit and vegetable consumption, BMI, and oral and oropharyngeal squamous cell carcinomas: analysis from the IARC multinational case-control study. Int J Cancer 2005; 118(9):2293-2297.
• Kreimer AR, Clifford GM, Boyle P, Franceschi S. Human papillomavirus types in head and neck squamous cell carcinomas worldwide: a systematic review. Cancer Epidemiol Biomarkers Prev . 2005; 14(2), 467-75.
• Kreimer AR, Clifford GM, Snijders PJ, Castellsagué X, Meijer CJLM, Pawlita M, Viscidi R, Herrero R, Franceschi S for the IARC Multicenter Oral Cancer Study Group. HPV16 viral load and serologic biomarkers in oral and oropharyngeal squamous cell carcinomas. International Journal of Cancer 2005; 115(2), 329-32.
• Kreimer AR, Alberg AJ, Viscidi RP, Gillison ML. Gender Differences in Sexual Biomarkers and Behaviors Associated With Human Papillomavirus-16, -18, and -33 Seroprevalence. Sex Transm Dis. 2004;31(4):247-256.
• Kreimer AR, Alberg AJ, Daniel R, Gravitt PE, Viscidi RP, Garrett ES, Shah KV, Gillison ML. Oral human papillomavirus infection in adults is associated with sexual behavior and HIV serostatus. Journal of Infectious Diseases. 2004;189(4):686-98.