Linda,

Even if the original primary tests positive for HPV with her smoking history I doubt that will have any bearing on this second primary which is likely a result of the tobacco history. The original HPV research demonstrated that HPV responds better to Tx and (therefore) has a less chance of recurrence compared to non HPV positive SCC. Further papers have indicated that when years of tobacco history are added to mix with a HPV positive test it changes the estimated outcome in a negative way moving toward a HPV negative Dx. Please remember this is purely a statistical approach and may not at all represent what actually happens to any one patient.