Cancers of the Anal Canal: Diagnosis, Treatment and Future Strategies

Bown, Emma; Shah, Vikas; Sridhar, T.; Boyle, Kirsten; Hemingway, David; Yeung, Justin Ming

doi:10.2217/fon.14.23

Cited by 9 publications

(25 citation statements)

References 105 publications

(115 reference statements)

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“…Viral DNA load in the anal lavage was comparable to that in the vaginal lavage, indicating possible viral shedding in the anal tract. Few studies have attempted to monitor viral infection in the anal tract (Bown et al , 2014; Liszewski et al , 2014; Wells et al , 2014). Our study demonstrated the feasibility of using anal lavage samples as a diagnostic tool.…”

Section: Discussionmentioning

confidence: 99%

Tracking vaginal, anal and oral infection in a mouse papillomavirus infection model

Budgeon

Cladel

et al. 2015

Journal of General Virology

104

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Noninvasive and practical techniques to longitudinally track viral infection are sought after in clinical practice. We report a proof-of-principle study to monitor the viral DNA copy number using a newly established mouse papillomavirus (MmuPV1) mucosal infection model. We hypothesized that viral presence could be identified and quantified by collecting lavage samples from cervicovaginal, anal and oral sites. Nude mice infected at these sites with infectious MmuPV1 were tracked for up to 23 weeks starting at 6 weeks post-infection. Viral DNA copy number was determined by SYBR Green Q-PCR analysis. In addition, we tracked viral DNA load through three complete oestrous cycles to pinpoint whether there was a correlation between the DNA load and the four stages of the oestrous cycle. Our results showed that high viral DNA copy number was reproducibly detected from both anal and cervicovaginal lavage samples. The infection and disease progression were further confirmed by histology, cytology, in situ hybridization, immunohistochemistry and transmission electron microscopy. Interestingly, the viral copy number fluctuated over the oestrous cycle, with the highest level at the oestrus stage, implying that multiple sampling might be necessary to provide a reliable diagnosis. Virus DNA was detected in oral lavage samples at a later time after infection. Lower viral DNA load was found in oral samples when compared with those in anal and vaginal tracts. To our knowledge, our study is the first in vivo study to sequentially monitor papillomavirus infection from mucosal anal, oral and vaginal tracts in a preclinical model.

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Section: Discussionmentioning

confidence: 99%

Tracking vaginal, anal and oral infection in a mouse papillomavirus infection model

Budgeon

Cladel

et al. 2015

Journal of General Virology

104

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“…[ 1 , 4 , 8 – 15 ] Accumulating evidence from countries in North America and Europe show that the incidence of HPV-associated oropharyngeal squamous cell carcinoma (OPSCC) and anal squamous cell carcinoma (ASCC) has increased over the past 2 to 4 decades, particularly among men. [ 6 , 7 , 9 , 10 , 12 – 19 ] Data on the epidemiology of HPV-associated cancers in Asia are more limited, but cancer registry-based studies in Korea and Taiwan found similar increases in HPV-related OPSCC. [ 20 , 21 ] Trends in other Asian countries, and across Asian ethnic groups, have not been previously studied.…”

Section: Introductionmentioning

confidence: 99%

Incidence, Trends and Ethnic Differences of Oropharyngeal, Anal and Cervical Cancers: Singapore, 1968-2012

Lam

Lim

Chow³

et al. 2015

PLoS ONE

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In recent decades, several Western countries have reported an increase in oropharyngeal and anal cancers caused by human papillomavirus (HPV). Trends in HPV-associated cancers in Asia have not been as well described. We describe the epidemiology of potentially HPV-related cancers reported to the Singapore Cancer Registry from 1968–2012. Analysis included 998 oropharyngeal squamous cell carcinoma (OPSCC), 183 anal squamous cell carcinoma (ASCC) and 8,019 invasive cervical cancer (ICC) cases. Additionally, 368 anal non-squamous cell carcinoma (ANSCC) and 2,018 non-oropharyngeal head and neck carcinoma (non-OP HNC) cases were included as comparators. Age-standardized incidence rates (ASR) were determined by gender and ethnicity (Chinese, Malay and Indian). Joinpoint regression was used to evaluate annual percentage change (APC) in incidence. OPSCC incidence increased in both genders (men 1993–2012, APC = 1.9%, p<0.001; women 1968–2012, APC = 2.0%, p = 0.01) and was 5 times higher in men than women. In contrast, non-OP HNC incidence declined between 1968–2012 among men (APC = -1.6%, p<0.001) and women (APC = -0.4%, p = 0.06). ASCC and ANSCC were rare (ASR = 0.2 and 0.7 per 100,000 person-years, respectively) and did not change significantly over time except for increasing ANSCCs in men (APC = 2.8%, p<0.001). ICC was the most common HPV-associated cancer (ASR = 19.9 per 100,000 person-years) but declined significantly between 1968–2012 (APC = -2.4%). Incidence of each cancer varied across ethnicities. Similar to trends in Western countries, OPSCC incidence increased in recent years, while non-OP HNC decreased. ICC remains the most common HPV-related cancer in Singapore, but Pap screening programs have led to consistently decreasing incidence.

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“…Anal mucinous adenocarcinoma [ Figure 16 ] is a rare malignancy accounting for about 3% of anal cancers. [ 23 24 ] Squamous cell carcinoma is similarly rare, but is strongly associated with the human papillomavirus. Presentation of anal cancer is variable, but generally includes anal pain, bleeding, or itching.…”

Section: Casesmentioning

confidence: 99%