Age-Related Prevalence of Anal Cancer Precursors in Homosexual Men: The EXPLORE Study

Chin‐Hong, Peter; Vittinghoff, Eric; Cranston, Ross D.; Browne, L. Walden; Buchbinder, Susan; Colfax, Grant; Costa, Maria Da; Darragh, Teresa M.; Benet, Dana Jones; Judson, Franklyn N.; Koblin, Beryl A.; Mayer, Kenneth H.; Palefsky, Joel M.

doi:10.1093/jnci/dji163

Cited by 199 publications

(127 citation statements)

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“…Information about the occurrence of AIN is, however, still limited, the prevalence and incidence having been examined mainly in selected groups, e.g., men who have sex with men and HIV-positive patients; [7][8][9][10][11][12][13][14][15] few studies have included women. 7,13,15 Knowledge about the incidence of AIN in the general population is necessary for understanding the natural history of AIN and anal cancer.…”

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Trends in incidence of anal cancer and high‐grade anal intraepithelial neoplasia in Denmark, 1978–2008

Nielsen

Munk

Kjær

2011

Intl Journal of Cancer

107

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The aim of the study was to determine the incidences of anal cancer and high-grade anal intraepithelial neoplasia (AIN2/3) over time in Danish women and men. Describing the burden of anal cancer and AIN may be valuable in future evaluations of the human papillomavirus (HPV) vaccine. We included all anal cancers in the Danish Cancer Register in the period 1978-2008 and all cases of AIN2/3 in the Danish Registry of Pathology. Overall and age-, period-and histology-specific incidence rates were estimated. During the 30-year period, 2,187 anal cancers were identified, two thirds of which were in women. Between 1978Between -1982Between and 2003Between -2008, the age-standardized incidence rate of anal cancer increased from 0.68 to 1.48 per 100,000 person-years in women and from 0.45 to 0.80 per 100,000 person-years in men. Although there is no systematic screening for AIN in Denmark, we nevertheless identified 608 cases of AIN2/3 during the study period. The average annual percentage change of 5% between 1998 and 2008 represents a steep increase in the incidence of AIN in both genders. Furthermore, the incidence rate of HPV-associated anal cancers increased significantly, whereas that of non-HPV-associated histological types levelled out or even declined during the 30 years of observation. In women, the increase in HPV-associated cancers was more pronounced among those under 60 years of age. Our findings indicate that vaccines against HPV might play an important role in the prevention of anal cancer and its precursor lesions.Anal cancer is relatively rare, representing less than 5% of cancers in the lower gastrointestinal tract, 1 and it is more common in women than in men. Over the past few decades, the incidence of anal cancer has been increasing throughout the world in both genders. In Denmark, a marked increase in the incidence of anal cancer was reported nearly 20 years ago, 2 with the greatest increase among women and men residing in the capital area. This led to investigations in the other Nordic countries and the United States, where similar patterns were observed; it was proposed that the increase was due to changing patterns in sexual behaviour. 3 In general, anal cancer has a fair prognosis, with 5-year survival rates greater than 70%, depending on factors such as gender, tumour stage and response to chemotherapy and radiation. 1 According to data from the SEER programme in the United States, the survival rate has improved substantially in women but not in men. 4 Smoking, sexual practices and immunosuppression have been reported to increase the risk for anal cancer. 1,[5][6][7][8] The most important causative agent is, however, infection with human papillomavirus (HPV).Anal intraepithelial neoplasia (AIN) is the precursor lesion for anal cancer. Information about the occurrence of AIN is, however, still limited, the prevalence and incidence having been examined mainly in selected groups, e.g., men who have sex with men and HIV-positive patients; 7-15 few studies have included women. 7,13,15 Knowledge a...

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confidence: 99%

Trends in incidence of anal cancer and high‐grade anal intraepithelial neoplasia in Denmark, 1978–2008

Nielsen

Munk

Kjær

2011

Intl Journal of Cancer

107

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“…13 En los hombres con VIH y que practican coito anal con hombres está demostrado el desarrollo del cáncer anal; pero la asociación del VIH con la progresión del cáncer anal es difícil de comprobar. 9,16 El VPH es una infección asintomática que lleva al desarrollo de cáncer en una minoría de los pacientes que sufren esta infección por largo tiempo. Informes recientes indican que los sujetos con VIH+ viven mayor tiempo gracias a la terapia antirretroviral y tienen un aumento en la incidencia del cáncer anal.…”

Section: Discussionunclassified

“…Informes recientes indican que los sujetos con VIH+ viven mayor tiempo gracias a la terapia antirretroviral y tienen un aumento en la incidencia del cáncer anal. 9,10 Este incremento de displasia y cáncer anal se ha observado en los pacientes VIH+ que tienen relaciones hombre con hombre, en los pacientes VIH+ heterosexuales y en las mujeres VIH+ que niegan relaciones anales. Los pacientes VIH+ son más susceptibles de presentar displasia de bajo o alto grado y de progresar a alto grado en un período de 2 años.…”

Section: Discussionunclassified

“…Los pacientes VIH+ son más susceptibles de presentar displasia de bajo o alto grado y de progresar a alto grado en un período de 2 años. 9,17,18 Estos dos hallazgos se presentan más frecuentemente cuando la cuenta de CD4 es < 200 células/mL.…”

Section: Discussionunclassified

“…7 En contraste con la prevalencia asociada a la edad de la infección por VPH del cérvix en mujeres, que disminuye a partir de los 30 años, la prevalencia de la infección por VPH del conducto anal en HSH y VIH positivos es alta; significa un 50 a 60 por ciento y permanece constante durante toda la vida. 8,9 Esto podría estar relacionado a la infección por nuevos tipos de VPH resultado del gran número de parejas sexuales durante la vida de los pacientes HSH.…”

Section: Introductionunclassified

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Concordancia histopatológica entre la citología y la biopsia anal en hombres que tienen sexo con hombres portadores de VIH y neoplasia intraepitelial anal asociada a VPH

Ríos¹,

Cabezas

Sobarzo

2015

Rev. Med. UCSG

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ResumenObjetivo: determinar la concordancia de los resultados de la citología y la biopsia anal en hombres que tienen sexo con hombres (HSH) portadores de VIH y neoplasia intraepitelial anal (NIA) asociada a virus del papiloma humano (VPH). Materiales y métodos: estudio observacional transversal, de diciembre de 2011 a diciembre de 2013 para determinar la concordancia de los resultados de la citología y la biopsia anal en hombres que tienen sexo con hombres (HSH) portadores de VIH y NIA asociada a VPH en pacientes del hospital de Infectología del Centro Médico Nacional la Raza. Se realizó análisis estadísticos descriptivos. Resultados: se estudiaron 92 sujetos VIH positivos y VPH positivo, el reporte histopatológico definitivo de las biopsias anales fueron: neoplasia intraepitelial de bajo grado en 39 %, neoplasia intraepitelial de alto grado 4 %, células atípicas de significado incierto 3 %, normales en 27 %, con cambios inflamatorios reactivos en 23 % y muestras inadecuadas para el diagnóstico el 9 %. La concordancia observada entre los dos métodos diagnósticos fue de 0.90 según alfa de Crobanch. Conclusión: el grado de concordancia del 90 % de las biopsias y citologías anales, indica que son buenos métodos de seguimiento de los pacientes infectados con VIH y VPH, y permite detectar en forma oportuna lesiones precancerígenas, brindando diagnóstico y tratamiento oportuno.PALABRAS CLAVE: neoplasias, carcinoma in situ, infección por Papillomavirus, VIH, conducta sexual. Abstract Objective: to determine the matching of the results of cytology and anal biopsy in men who have sex with men (MSM) who are HIV carriers and anal intraepithelial neoplasia (AIN) associated with human papillomavirus (HPV). Materials and methods: cross-sectional observational study from December 2011 to December 2013 to determine the matching of the results of cytology and anal biopsy in men who have sex with men (MSM) who are HIV carriers and AIN associated with HPV in patients with Infectious Diseases at the La Raza National Medical Center. Descriptive statistical analysis was performed. Results: 92 HIV positive and HPV positive subjects were studied, the final histopathological report of anal biopsies were: low-grade intraepithelial neoplasia in 39%, high-grade intraepithelial neoplasia 4%, atypical cells of undetermined significance 3%, normal in 27, with reactive inflammatory changes in 23% and inadequate samples for diagnosis 9%. The matching observed between both diagnostic methods was 0.90 based on Cronbach's alpha. Conclusion: the matching degree of 90% of the anal Pap smears and biopsies indicates that they are good monitoring methods of patients infected with HIV and HPV, and can detect precancerous lesions in a timely manner, providing prompt diagnosis and treatment.KEYWORDS: neoplasms, carcinoma in situ, Papillomavirus infections, HIV, sexual behavior.Resumo Objetivo: determinar a concordância dos resultados do exame citológico e a biópsia anal em homens que fazem sexo com homens (HSH) portadores de HIV e neoplasia intraepitelia...

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Patient Symptomatology in Anal Dysplasia

et al. 2015

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Age-Related Prevalence of Anal Cancer Precursors in Homosexual Men: The EXPLORE Study

Abstract: Sexually active HIV-negative MSM in all age groups have a high prevalence of ASILs, possibly reflecting their ongoing sexual exposure to HPV.

Cited by 199 publications

References 40 publications

Trends in incidence of anal cancer and high‐grade anal intraepithelial neoplasia in Denmark, 1978–2008

Trends in incidence of anal cancer and high‐grade anal intraepithelial neoplasia in Denmark, 1978–2008

Concordancia histopatológica entre la citología y la biopsia anal en hombres que tienen sexo con hombres portadores de VIH y neoplasia intraepitelial anal asociada a VPH

Patient Symptomatology in Anal Dysplasia

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