Of the following statements about Recurrent Laryngeal papillomatosis are true, Except

Recurrent Laryngeal Papillomatosis / Recurrent Respiratory Papillomatosis Etiology Associated with Human Papilloma Virus infection (HPV) HPV6 and HPV 11 are most commonly associated with laryngeal disease whereas HPV 16 and HPV 18 are less commonly associated. HPV11 is associated with a more aggressive disease and makes the patient more prone to malignant change Thus HPV 11 is more virulent Epidemiology Most commonly occur in children Male female ratio - same (first born vaginally delivered child of a teenage mother is most prone) Transmission Exact mode of transmission is not known. There is recognized transmission from genital was. Veical transmission of virus from mother to child can occur either as ascending uterine infection or through direct contact in bih canal. Malignant transformation in a case of papilloma occurs most commonly in distal bronchopulmonary tree and prognosis is universally poor