Burden of anal squamous cell carcinoma, squamous intraepithelial lesions and HPV16 infection in solid organ transplant recipients: A systematic review and meta-analysis

Abstract

Anal human papillomavirus (HPV) infection, especially HPV16, is an important etiologic factor of anal precancerous lesions and anal squamous cell carcinoma (SCC). 1,2 These anal HPV complications have been shown to occur at increased rates in specific groups, such as human immunodeficiency virus (HIV)-positive patients, 3 men who have sex with men (MSM), 3 women with a previous history of genital neoplasia, 4,5 and solid organ transplant recipients

A meta‐analysis of anal cancer incidence by risk group: Toward a unified anal cancer risk scale

“…A long established excess risk of anal cancer in SOTRs 9,11 has led to one professional society recently recommending anal cancer screening in this group 48 . However, as shown previously, 15 and further clarified here, considerable risk stratification exists within this population, most notably according to gender and years since transplantation, with IR reaching 50 per 100 000 py in females ≥10 years since transplant.…”

“…MEDLINE was searched using the terms (“anal” OR “anus” OR “anal canal”) in combination with (“incidence” OR “IR” OR “SIR” OR “hazard ratio” OR “HR”), any restrictions by calendar period, geographical region or language. Eligible studies were also identified from a number of relevant meta‐analyses, including those focusing on MSM, 8 PLHIV, 9 women diagnosed with HPV‐related gynecological precancerous lesions or cancer 10,13 or SOTRs 9,11 . Where several publications described the same study population, only the most recent update was included.…”

“…Eligible studies were also identified from a number of relevant meta-analyses, including those focusing on MSM, 8 PLHIV, 9 women diagnosed with HPV-related gynecological precancerous lesions or cancer 10,13 or SOTRs. 9,11 Where several publications described the same study population, only the most recent update was included.…”

“…Thus, there exist a number of groups at known elevated anal cancer risk. These include men who have sex with men (MSM), 8 persons living with HIV (PLHIV), 9 women with HPV‐related gynecological cancer or precancerous lesions, 10 as well as iatrogenically immunosuppressed recipients, most notably solid organ transplant recipients (SOTRs) 11 …”

“…These include men who have sex with men (MSM), 8 persons living with HIV (PLHIV), 9 women with HPV-related gynecological cancer or precancerous lesions, 10 as well as iatrogenically immunosuppressed recipients, most notably solid organ transplant recipients (SOTRs). 11 Anal cancer risks are often articulated as standardized incidence ratios (SIRs), comparing observed anal cancers with those expected among the general population of similar age, gender and/or time period. SIRs are a useful statistic to contribute to judgments of causal associations, but are not easily comparable with each other, given that they are standardized to general populations with different underlying rates.…”