Cigarette Smoking and the Risk of Anogenital Cancer

Daling, Janet R.; Sherman, Karen J.; Hislop, T. Gregory; Maden, Christopher; Mandelson, Margaret T.; Beckmann, Anna Marie; Weiss, Noel S.

doi:10.1093/oxfordjournals.aje.a116270

Cited by 265 publications

(129 citation statements)

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“…Three studies reported that VV-SCC patients tend to have shorter education, lower household incomes and more often belong to lower social strata of society than controls. 2,8,16,17 Our findings regarding tobacco consumption are in agreement with prior reports All univariate odds ratios are adjusted for age at the time of the diagnosis.-2 Numbers and percentages of respondents who reported that they had had the disease (or HIV test) in question. In the calculation of odds ratios for these variables, respondents reporting no such disease (or HIV test) served as the reference group.-3 Numbers and percentages of respondents who reported that their male partner had had the disease in question.…”

Section: Discussionsupporting

confidence: 87%

Risk factors for invasive squamous cell carcinoma of the vulva and vagina—Population‐based case–control study in Denmark

Madsen

Jensen

Brule

et al. 2008

Intl Journal of Cancer

153

103

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The etiology of vulvar and vaginal squamous cell carcinoma (VV-SCC) has received little attention. A total of 182 women with invasive VV-SCC (116 with VV-SCC vulva , 66 with VV-SCC vagina ), 164 uterine corpus cancer controls and 518 population controls were interviewed in a population-based case-control study in Denmark, and 87 (48%) of the VV-SCC cases had tissue samples examined for human papillomavirus (HPV) DNA using the GP51/61 PCR-EIA assay and subsequent reverse line blotting for HPV typing. Logistic regression-derived odds ratios with 95% confidence intervals served as relative risks. Cervical cancer-associated high-risk HPVs (hrHPVs) were detectable in most (89%) examined cases of VV-SCC vagina and in half (50%) of cases of VV-SCC vulva (p < 0.001). In site-specific multivariate logistic regression analyses, statistically significant risk factors for both VV-SCC vulva and VV-SCC vagina included measures of hrHPV exposure (anogenital warts for VV-SCC vulva ; cervical neoplasia and poor genital hygiene for VV-SCC vagina ), tobacco smoking and alcohol consumption. Furthermore, socioeconomic variables (marital status and years at school) were associated with risk of VV-SCC vulva . Comparing hrHPV-positive and hrHPV-negative VV-SCCs in polytomous logistic regression analysis revealed that tobacco smoking and cervical neoplasia were significant risk factors only for hrHPV-positive VV-SCCs. Our study shows that VV-SCC vulva and VV-SCC vagina share measures of prior hrHPV exposure, tobacco smoking and alcohol consumption as statistically significant risk factors. HPV vaccination programs aimed at reducing the burden of cervical cancers are likely to also provide considerable protection against VV-SCCs.

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Section: Discussionsupporting

confidence: 87%

Risk factors for invasive squamous cell carcinoma of the vulva and vagina—Population‐based case–control study in Denmark

Madsen

Jensen

Brule

et al. 2008

Intl Journal of Cancer

153

103

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“…10 However, concern remains that smoking may be an etiologic factor only among certain subgroups 11 and that confounding by sexual factors may not have been ruled out. To explore this hypothesis, we analyzed the correlation between smoking and anal carinoma for the complete group of men and women in the current study population and then for various subgroups.…”

Section: Resultsmentioning

confidence: 99%

“…5,10,12,19,23 Current smoking at the time of diagnosis has been associated with all HPV-related squamous cell anogenital tumors, regardless of whether HPV DNA is present in the tumor. Because it appears that it is most important if patients with cancer are current smokers at the time of diagnosis, current smoking likely has a promotional effect at late stages of disease progression.…”

Section: Discussionmentioning

confidence: 99%

Human papillomavirus, smoking, and sexual practices in the etiology of anal cancer

Daling

Madeleine

Johnson

et al. 2004

Cancer

Self Cite

700

553

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BACKGROUNDThe incidence of anal cancer has increased among both men (160%) and women (78%) from 1973 to 2000 in the U.S. The authors conducted a population‐based case–control study of anal cancer to examine factors that may account for this increase.METHODSMen (n = 119 patients) and women (n = 187 patients) who were diagnosed with anal cancer between 1986 and 1998 in the Seattle area were ascertained through the local Surveillance, Epidemiology, and End Results registry. Control participants (n = 1700) were ascertained through random‐digit telephone dialing. Participants were interviewed in person and provided blood samples. Archival tumor tissue was tested for human papilloma virus (HPV) DNA, and serum samples were tested for HPV type 16 (HPV‐16).RESULTSOverall, 88% of tumors (all histologies) in the study were found to be positive for HPV. HPV‐16 was the most frequent HPV type detected (73% of all tumors), followed by HPV‐18 (6.9%), regardless of gender. However, 97.7% of tumors from men who were not exclusively heterosexual contained HPV DNA. The risk of anal cancer increased among men (odds ratio [OR], 5.3; 95% confidence interval [95% CI], 2.4–12.0) and women (OR, 11.0; 95% CI, 5.5–22.1) who had ≥ 15 sexual partners during their lifetime. Among men who were not exclusively heterosexual and women, receptive anal intercourse was related strongly to the risk of anal cancer (OR, 6.8 [95% CI, 1.4–33.8] and OR, 2.2 [95% CI, 1.4–3.3], respectively). Current smokers among men and women were at particularly high risk for anal cancer, independent of age and other risk factors (OR, 3.9 [95% CI, 1.9–8.0] and OR, 3.8 [95% CI, 2.4–6.2], respectively).CONCLUSIONSThe high proportion of tumors with detectable HPV suggests that infection with HPV is a necessary cause of anal cancer, similar to that of cervical cancer. Increases in the prevalence of exposures, such as cigarette smoking, anal intercourse, HPV infection, and the number of lifetime sexual partners, may account for the increasing incidence of anal cancer in men and women. Cancer 2004. © 2004 American Cancer Society.

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“…There is also mounting evidence that the same types of HPV, particularly type 16, are involved in the aetiology of most anal epidermoid carcinomas (Daling et al, 1992;Holm et al, 1994;Frisch et al, 1997). However, other factors involved in the development of anal cancer are poorly characterized.…”

Section: Discussionmentioning

confidence: 99%

Benign anal lesions, inflammatory bowel disease and risk for high-risk human papillomavirus-positive and -negative anal carcinoma

Frisch

Glimelius²,

Brule³

et al. 1998

Br J Cancer

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Summary A central role in anal carcinogenesis of high-risk types of human papillomaviruses (hrHPV) was recently established, but the possible role of benign anal lesions has not been addressed in hrHPV-positive and -negative anal cancers. As part of a population-based case-control study in Denmark and Sweden, we interviewed 417 case patients (93 men and 324 women) diagnosed during the period 1991-94 with invasive or in situ anal cancer, 534 patients with adenocarcinoma of the rectum and 554 population controls. Anal cancer specimens (n = 388) were tested for HPV by the polymerase chain reaction. Excluding the 5 years immediately before diagnosis, men, but not women, with anal cancer reported a history of haemorrhoids [multivariate odds ratio (OR) 1.8; 95% confidence interval (Cl) 1.04-3.2] and unspecific anal irritation (OR 4.5; Cl 2.3-8.7) significantly more often than controls. Women with anal cancer did not report a history of benign anal lesions other than anal abscess to any greater extent than controls, but they had used anal suppositories more often (OR 1.5; Cl 1.1-2.0). Patients with hrHPV in anal cancer tissue (84%) and those without (16%) reported similar histories of most benign anal lesions, but anal fissure or fistula was more common among hrHPV-positive cases. Ulcerative colitis and Crohn's disease, reported by <11% of study participants, were not associated with anal cancer risk. The higher proportion of hrHPV-positive anal cancers among case patients with anal fissure or fistula suggests that such mucosal lesions may provide direct viral access to basal epithelial layers. Since risk associations with benign anal lesions in men may be confounded by unreported sexual behaviour, and since risk associations in women were generally negative, it seems unlikely that benign anal lesions act as promoters in hrHPV-associated anal carcinogenesis. Moreover, benign anal lesions appear not to be linked to an alternative, hrHPV-unassociated causal pathway to anal cancer. Ulcerative colitis and Crohn's disease were not supported as causal factors for anal cancer.Keywords: anus neoplasms; risk factors; haemorrhoids; anal fistula; anal fissure; inflammatory bowel diseases; ulcerative colitis; Crohn's disease The incidence of epidermoid anal cancer, a rare neoplasm of the anal canal and perianal skin, has increased considerably during the past decades (Goldman et al, 1989;Frisch et al, 1993;. It has been shown that anal cancer has a sexually transmitted aetiology (Daling et al, 1987;Holly et al, 1989;Frisch et al, 1997). Substantial evidence now points to the causal involvement of certain high-risk types of human papillomaviruses (hrHPV), notably HPV type 16, in the majority of anal cancers (Holm et al, 1994;Frisch et al, 1997). One case-control study (Holly et al, 1989) provided data that were interpreted as supportive of the old belief that anal inflammation predisposes to anal cancer (Brofeldt, 1927;Buckwalter and Jurayj, 1957). However, another case-control study (Holmes et al, 1988) and two subsequent cohort s...

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Cigarette Smoking and the Risk of Anogenital Cancer

Cited by 265 publications

References 0 publications

Risk factors for invasive squamous cell carcinoma of the vulva and vagina—Population‐based case–control study in Denmark

Risk factors for invasive squamous cell carcinoma of the vulva and vagina—Population‐based case–control study in Denmark

Human papillomavirus, smoking, and sexual practices in the etiology of anal cancer

Benign anal lesions, inflammatory bowel disease and risk for high-risk human papillomavirus-positive and -negative anal carcinoma

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