Cancer in a Population-based Cohort of Men and Women in Registered Homosexual Partnerships

Frisch, Mørten; Smith, Else; Grulich, Andrew E.; Johansen, Christoffer

doi:10.1093/aje/kwg067

Cited by 123 publications

(70 citation statements)

References 24 publications

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“…Men who had practiced anal sex with two or more female partners were also at increased risk, but numbers were unstable. Although some study participants may have been reluctant to report certain sexual details, the finding that men with same-sex experience are not at increased risk of developing penile SCC accords well with prior reports of no conspicuous penile SCC risk in gay men (4,24).…”

Section: Discussionsupporting

confidence: 83%

Risk Factors for Squamous Cell Carcinoma of the Penis—Population-Based Case-Control Study in Denmark

Madsen

Brule²,

Jensen

et al. 2008

Cancer Epidemiology, Biomarkers &Amp; Prevention

111

103

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Few etiologic studies of squamous cell carcinoma (SCC) of the penis have been carried out in populations where childhood circumcision is rare. A total of 71 patients with invasive (n = 53) or in situ (n = 18) penile SCC, 86 prostate cancer controls, and 103 population controls were interviewed in a population-based casecontrol study in Denmark. For 37 penile SCC patients, tissue samples were PCR examined for human papillomavirus (HPV) DNA. Overall, 65% of PCR-examined penile SCCs were high-risk HPV-positive, most of which (22 of 24; 92%) were due to HPV16. Penile SCC risk was positively associated with measures of early and high sexual activity, including lifetime number of female sex partners, number of female sex partners before age 20, age at first intercourse, penile-oral sex, a history of anogenital warts, and never having used condoms. Histories of phimosis and priapism at least 5 years before diagnosis were also significant risk factors, whereas alcohol abstinence was associated with reduced risk. Our study confirms sexually transmitted HPV16 infection and phimosis as major risk factors for penile SCC and suggests that penileoral sex may be an important means of viral transmission. The association with priapism was unexpected and needs replication. (Cancer Epidemiol Biomarkers Prev 2008;17(10):2683 -91)

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Section: Discussionsupporting

confidence: 83%

Risk Factors for Squamous Cell Carcinoma of the Penis—Population-Based Case-Control Study in Denmark

Madsen

Brule²,

Jensen

et al. 2008

Cancer Epidemiology, Biomarkers &Amp; Prevention

111

103

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“…In one study there were significantly higher rates of cervical cancer in both lesbian and bisexual women, and higher rates of uterine cancer in lesbians but lower rates in bisexual women 35. Another study found lower rates of cervical carcinoma in situ in lesbians 36. There was no significant difference in rates of endometriosis and fibroids 12, 31, 37.…”

Section: Resultsmentioning

confidence: 96%

Lesbian and bisexual women's gynaecological conditions: a systematic review and exploratory meta‐analysis

Robinson

Galloway

Bewley

et al. 2016

BJOG

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BackgroundLittle is known about the gynaecological health of lesbian and bisexual (LB) women.ObjectivesTo examine differences in incidence and/or prevalence of gynaecological conditions in LB compared with heterosexual women.Search strategyThe systematic review protocol was prospectively registered (PROSPERO‐CRD42015027091) and searches conducted in seven databases.Selection criteriaComparative studies published 2000–2015, reporting any benign (non‐infectious) and/or malignant gynaecological conditions with no language or setting restrictions.Data collection and analysisInclusions, data extraction and quality assessment were conducted in duplicate. Meta‐analyses of condition prevalence rates were conducted where ≥3 studies reported results.Main resultsFrom 567 records, 47 full papers were examined and 11 studies of mixed designs included. No studies directly addressing the question were found. Two chronic pelvic pain studies reported higher rates in bisexual compared with heterosexual women (38.5 versus 28.2% and 18.6 versus 6.4%). Meta‐analyses showed no statistically significant differences in polycystic ovarian syndrome, endometriosis and fibroids. There was a higher rate of cervical cancer in bisexual than heterosexual women [odds ratio (OR) = 1.94; 95% CI 1.46–2.59] but no difference overall (OR = 0.76; 95% CI 0.15–3.92). There was a lower rate of uterine cancer in lesbian than heterosexual women (OR = 0.28; 95% CI 0.11–0.73) and overall (OR = 0.36; 95% CI 0.13–0.97), but no difference in bisexual women (OR = 0.43; 95% CI 0.06–3.07).ConclusionsMore bisexual women may experience chronic pelvic pain and cervical cancer than heterosexual women. There is no information on potential confounders. Better evidence is required, preferably monitoring sexual orientation in research using the existing validated measure and fully reporting results.Tweetable abstractLesbians have less uterine cancer than heterosexual women; bisexuals have more pelvic pain and cervical cancer.

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“…Among 5000 Danish persons in same-sex partnerships, there was no evidence of an increased cancer incidence, except among gay men with AIDS. 4 …”

Section: Cancer Survivorship and Sexual Orientationmentioning

confidence: 99%

Proper selection and classification criteria are necessary in the evaluation of the new TNM staging system for gastric cancer

Marrelli

Roviello

2011

Cancer

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We read with great interest the article by Jung and coworkers on the validity of the seventh TNM classification of gastric cancer (GC). 1 The Authors concluded that it may be considered valid, but proposed a new hybrid TNM classification. In our opinion, several potential bias due to selection and classification criteria could have affected the results: 1) In the seventh TNM, carcinomas with the epicenter located within 5 cm of the esophagogastric junction (EGJ) and also extending to the esophagus are considered and staged as esophageal cancer; then, they should be excluded from GC series. According to the reported methods, this selection was not performed. The different staging system and prognosis of EGJ carcinomas could have affected the results of the study. 2) Although the new TNM recommends a minimum number of 15 lymph nodes to be analyzed, this is not an exclusion criteria for TNM classification. Indeed, the new staging system need to be applied even when fewer lymph nodes are removed, as it occurs in a large proportion of GC patients in the world. 2 Being the interaction between the number of analyzed nodes and pN status 1 of the main problems of staging systems, the new TNM requires validation in this setting. 3) Residual tumor (R) classification, although being an important prognostic factor for GC, is not part of the TNM stage. It is unclear why the authors decided to exclude R1/R2 cases from their analysis. Survival probabilities may have been overestimated, particularly in advanced stages. 4) In the new TNM, cases with positive peritoneal cytology (cyþ) are now considered as M1, and included in stage IV. As such, it is not correct that ''stage IV disease is only defined for patients with a definitive distant metastasis''. Furthermore, no information about peritoneal cytology is provided by the Authors. In our opinion, potential stage migration and prognostic uniformity between cyþM0 and M1 cases in stage IV of the seventh TNM need to be clinically validated.In conclusion, proper selection and classification criteria should be used in the evaluation of the new TNM staging system for GC. We believe that, until these criteria are applied, any estimation of its validity or proposals of new staging systems remain aleatory.

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Cancer in a Population-based Cohort of Men and Women in Registered Homosexual Partnerships

Cited by 123 publications

References 24 publications

Risk Factors for Squamous Cell Carcinoma of the Penis—Population-Based Case-Control Study in Denmark

Risk Factors for Squamous Cell Carcinoma of the Penis—Population-Based Case-Control Study in Denmark

Lesbian and bisexual women's gynaecological conditions: a systematic review and exploratory meta‐analysis

Proper selection and classification criteria are necessary in the evaluation of the new TNM staging system for gastric cancer

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