Virological and EpidEmiological aspEcts of anal carcinoma: currEnt and futurE challEngEs

Abstract

Human papillomavirus infection, a sexually transmitted disease studied mainly in women due to its link to uterine cervical carcinoma, has become a health problem in men also, mainly by the significant increase of the prevalence and incidence of anal intraepithelial neoplasia and anal carcinoma in specific groups, such as men who have sex with men, HIV-seropositive and immunocompromised. The anal carcinoma, as cervical cancer, is associated with highrisk oncogenic HPV in 90% of cases, with HPV 16 as the predominant, followed by HPV 18. This fact occurs in a moment when there are no management protocols for HPV infection in the anal area, either preventive, diagnostic or therapeutic, and without an unique specialty that embraces the problem of HPV anogenital infection in men as does the gynecology for women, causing a dispersion of expertise. Added to this, there are still many doubts in the medical and general population about prophylactic vaccination for HPV in boys, and the absence of its distribution in a public health scale in most countries that still wait for statistical calculations to justify its use.