A 35-year-old man presents to the otolaryngology clinic with progressive hoarseness and throat discomfort for 4 weeks. He reports a 15-year history of smoking and occasional unprotected oral sex. Laryngoscopy reveals a warty, exophytic lesion on the left vocal cord. Biopsy confirms recurrent respiratory papillomatosis (RRP) with HPV-11 detected on PCR. The patient is counselled about the natural history of the disease. Which of the following statements about HPV-11-associated RRP is MOST accurate?