Anal cancers attributed to human papillomavirus are more common in areas in Victoria, Australia, with higher HIV notifications

Sexual Health ◽  
2013 ◽  
Vol 10 (3) ◽  
pp. 220
Author(s):  
Lenka A. Vodstrcil ◽  
Jane Hocking ◽  
Tim R. H. Read ◽  
Andrew E. Grulich ◽  
Christopher K. Fairley
Keyword(s):  
Colon Cancer ◽  
Anal Cancer ◽  
Brain Cancer ◽  
Incidence Rate Ratio ◽  
Population Level ◽  
Incidence Rates ◽  
Notification Rate ◽  
Anal Squamous Cell Carcinoma ◽  
Male Age ◽  
Sex With Men

Background Anal cancer is more common in men who have sex with men with HIV. We aimed to determine if there was an association between anal squamous cell carcinoma (SCC) and HIV notifications in men in Victoria, Australia, at a population level. Methods: We calculated the male age-standardised incidence rates for anal SCC, brain cancer and colon cancer for each local government area (LGA) in Victoria from 1982 to 31 December 2010 using the Victorian Cancer Registry. Male HIV rates in each LGA were calculated using the Victorian HIV Registry. Results: There were 288 men diagnosed with anal SCC, 8793 with brain cancer and 23 938 with colon cancer in 57 LGAs. There were 3163 men notified with HIV during the same period in the same LGAs (range: 4–435 per LGA). There was a significant positive correlation (r = 0.45, P < 0.001, r2 = 0.20) between the age-standardised rate of anal SCC and the rate of HIV notifications in men in each LGA but no correlation between the male age-standardised rate of colon (Pearson’s r = –0.11, P = 0.40) or brain (r = –0.05, P = 0.71) cancers, and the rate of HIV. The rate of anal cancer was ~50% higher in LGAs with the highest HIV notification rate (incidence rate ratio = 1.47; 95% confidence interval: 1.10–1.97). Conclusions: At a population level, about one in five cases (r2 = 0.20) of anal SCCs in men are explained by the rate of HIV notifications in that LGA.

scholarly journals Investigating epidemiologic trends and the geographic distribution of patients with anal squamous cell carcinoma throughout Canada

2020 ◽  
Vol 27 (3) ◽  
Author(s):  
L. Cattelan ◽  
F. M. Ghazawi ◽  
M. Le ◽  
E. Savin ◽  
A. Zubarev ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Anal Cancer ◽  
Squamous Cell ◽  
Demographic Data ◽  
Cancer Registries ◽  
The United States ◽  
Incidence Rates ◽  
Anal Squamous Cell Carcinoma ◽  
Incidence And Mortality

Background Anal cancer is a rare disease, constituting 0.5% of new cancer cases in the United States. The most common subtype is squamous cell carcinoma (scc). Studies in several developed nations have reported on an increasing incidence of anal cancer in recent decades, and various risk factors pertaining to the pathogenesis of the disease have been identified, including infection with the human papillomavirus, tobacco use, and immunosuppression. The epidemiology and distribution of anal scc throughout Canada remain poorly understood, however. Methods Using 3 population-based cancer registries, a retrospective analysis of demographic data across Canada for 1992–2010 was performed. The incidence and mortality for anal scc was examined at the levels of provinces, cities, and the forward  sortation area (FSA) component (first 3 characters) of postal codes. Results During 1992–2010, 3720 individuals were diagnosed with anal scc in Canada; 64% were women. The overall national incidence rate was 6.3 cases per million population per year, with an average age at diagnosis of 60.4 years. The incidence increased over time, with significantly higher incidence rates documented in British Columbia and Nova Scotia (9.3 cases per million population each). Closer examination revealed clustering of cases in various urban centres and self-identified lgbtq communities in Toronto, Montreal, and Vancouver. Discussion This study provides, for the first time, a comprehensive analysis of the burden of anal scc in Canada, identifying susceptible populations and shedding light onto novel avenues of research to lower the incidence of anal cancer throughout the country.

33. Gradually decreasing anal cancer incidence in the HIV+ population in the Netherlands after a decade of cART

Sexual Health ◽  
2013 ◽  
Vol 10 (6) ◽  
pp. 586
Author(s):  
O. Richel ◽  
R. P. Van der Zee ◽  
C. Smit ◽  
H. J. C. De Vries ◽  
J. M. Prins
Keyword(s):  
Risk Factors ◽  
Alcohol Abuse ◽  
Anal Cancer ◽  
Cancer Incidence ◽  
Potential Risk ◽  
Incidence Rates ◽  
Hiv Patients ◽  
Hazard Ratios ◽  
Potential Risk Factors ◽  
Sex With Men

Background Anal cancer incidence has been increasing in the combined antiretroviral therapy (cART) era in HIV+ patients. In this study we surveyed trends in anal cancer incidence between 1995 and 2012, and analysed a range of potential risk factors. Methods: We retrieved data for all patients diagnosed with anal cancer from the Dutch HIV observational cohort (ATHENA) database. Incidence rates were calculated per 100 000 person-years of follow-up (FU), for the whole period of 18 years, and per 2-year blocks. Potential risk factors were analysed in a uni- and multivariable Cox proportional hazard model. Results: For all HIV+ patients, men who have sex with men (MSM), and heterosexual men and women, respectively, the incidence of anal cancer was 83 (95% CI 70–99), 116 (95% CI 95–140), 44 (95% CI 21–83) and 12 (95% 3–30) per 100 000 person-years of FU. In 2005–2006, a peak in incidence rates was observed of 114 (95% CI 74–169) in the total HIV population and 168 (95% CI 103–259) among HIV+ MSM, followed by a decrease to 72 (95% CI 42–113) and 100 (95% CI 56–164), respectively, in 2011–2012. Low nadir CD4 (<110), alcohol abuse and smoking were significantly associated with anal cancer in MSM, with hazard ratios (HR) of 2.41 (95%CI 1.5–3.89), 2.23 (95% CI 1.28–3.89) and 1.60 (95% CI 1.07–2.41), respectively. Conclusions: Anal cancer remains a serious problem in predominantly HIV+ MSM; however, it seems that incidence rates are levelling off. A low nadir CD4 count, alcohol abuse and smoking are risk factors for the development of anal cancer.

scholarly journals Association between rectal gonorrhoea and HIV incidence in men who have sex with men: a meta-analysis

2021 ◽  
pp. sextrans-2021-055254
Author(s):  
Deborah Donnell ◽  
Kidist Zewdie ◽  
Natasha Ratna ◽  
Veronica Miller ◽  
John Michael Saunders ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Population Level ◽  
Incidence Rates ◽  
Hiv Incidence ◽  
Art Initiation ◽  
Persons Living With Hiv ◽  
Hiv Exposure ◽  
Sex With Men ◽  
Sexual Health Clinics ◽  
Hiv Negative

BackgroundIncidence of rectal gonorrhoea (GC) has been hypothesised as a correlate of HIV exposure in prevention trials of men who have sex with men (MSM). High rectal GC incidence in MSM trials of new biomedical prevention drugs may provide supportive evidence for ongoing HIV risk. Empirical evidence of correlation between rectal GC and HIV incidence is needed to assess whether high rectal GC rates reliably correlate with high risk of HIV.MethodsRectal GC and HIV are routinely tested in sexual health clinics (SHCs) throughout England. Through routine surveillance data collected at visits to SHCs, we assessed HIV incidence and new rectal GC diagnoses in repeat visits by HIV-negative MSM between 2011 and 2018, predating widespread roll-out of pre-exposure prophylaxis. Meta-analysis regression assessed population-level association between HIV and rectal GC incidence over time.FindingsBetween 2011 and 2018, HIV and rectal GC incidence was assessed in 541 056 HIV-negative MSM attending SHCs in England. HIV incidence among MSM attending SHCs fell from 1.26/100 person-years (PYs) in 2011 to 0.28/100 PYs in 2018. Rectal GC rates increased from 3.5/100 PYs to 11.1/100 PYs over the same period. The rate of HIV incidence decreased by 22.3% for each percent increase in rectal GC (95% CI –30.8 to –14.7, p<0.001).InterpretationAmong the population of MSM attending SHCs in England, rectal GC rates increased substantially while HIV incidence rates decreased between 2011 and 2018. HIV incidence likely decreased through expanded HIV testing, prompt antiretroviral treatment (ART) initiation and increased viral suppression in persons living with HIV, interventions that did not decrease rectal GC. Rectal GC may not be an ideal proxy for HIV incidence in trials, as HIV exposure risk is complex and context dependent, given effective HIV prevention interventions in MSM.Introduction

Incidence rates for anal cancer in the United States: 1980-2009.

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 357-357 ◽  
Author(s):  
Lauren A. Eberly ◽  
Charles Wiggins ◽  
Itzhak Nir ◽  
Katherine T. Morris ◽  
John C. Russell ◽  
...  
Keyword(s):  
Anal Cancer ◽  
Squamous Cell ◽  
Direct Method ◽  
Cell Cancer ◽  
Temporal Trends ◽  
The United States ◽  
Incidence Rates ◽  
Seer Program ◽  
Anal Squamous Cell Carcinoma ◽  
The U.S

357 Background: Anal squamous cell carcinoma (SCC) is rare, but results in significant morbidity and mortality. The aim of this study was to characterize the trends of anal SCC in the U.S. between 1980-2009. Methods: Subjects were identified from records in the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program. The study included incident malignant squamous cell cancer of the anus, anal canal, and anorectum diagnosed among nine core areas of the SEER program from 1980-2009. Average annual age-adjusted incidence rates were calculated by the direct method with the U.S. 2000 standard population. 95% confidence intervals were calculated using the Tiwari adjustment. Temporal trends were assessed by joinpoint regression. Results: Incidence rates of anal cancer in the U.S. more than doubled during this period. A linear increase in anal cancer incidence rates was observed with an Annual Percent Change (APC) of 4.6 (p<0.01) for all races and both sexes-combined. Incidence rates were consistently greater for women than men, however, the increase in incidence rates was greater for men (APC=5.4, p<0.01) than for women (APC=4.3, p<0.01). Similar trends were seen for whites and blacks. Conclusions: Anal cancer is a relatively rare disease, yet incidence rates increased dramatically in the U.S. over the last three decades. Correlation of this increased incidence with HPV infection remains to be determined. [Table: see text]

Geographical clustering of anal cancer incidence in Australia

Sexual Health ◽  
2012 ◽  
Vol 9 (6) ◽  
pp. 509 ◽  
Author(s):  
I. Mary Poynten ◽  
Alicia N. Stein ◽  
E. Lynne Conway ◽  
Garrett Prestage ◽  
David G. Regan ◽  
...  
Keyword(s):  
Anal Cancer ◽  
Cancer Incidence ◽  
Age Groups ◽  
Incidence Rates ◽  
Homosexual Men ◽  
Male Population ◽  
Anal Squamous Cell Carcinoma ◽  
Increased Risk ◽  
High Prevalence ◽  
Homosexual Identity

Introduction: Homosexual men are at an increased risk of anal cancer. We aimed to establish the burden of anal squamous cell carcinoma (SCC) in those parts of Australia where homosexual men are most likely to live. Methods: Data on the proportion of homosexual male residents were obtained from published estimates. Men were categorised into three postcode groups by prevalence of men reporting homosexual identity. Male population data in age groups were extracted for each postcode group and analyses of cancer incidence were performed by postcode group. The analyses were restricted to 2000–2005. Results: Eight postcodes had populations where more than 10% of males reported homosexual identity (high prevalence) and 4–10% of men reported homosexual activity in a further 19 postcodes (medium prevalence). From 2000 to 2005, the average annual age-standardised incidence rates of anal SCC in males was 7.61 per 100 000 (95% confidence interval (CI): 4.68–10.55) and 2.21 per 100 000 (95% CI: 1.05–3.37) in high and medium prevalence postcodes, respectively. The corresponding incidence rate ratios compared with low prevalence postcodes (less than 4% of males reported homosexual identity) were 9.6 (95% CI: 6.6–14.1) for the high prevalence and 2.4 (95% CI: 1.4–4.1) for the medium prevalence postcodes. Conclusion: A substantial concentration of the burden of anal cancer occurred among areas where large proportions of homosexual men reside. These results should guide the prioritisation of health service investment in anal cancer treatment and prevention to appropriate geographical areas.

scholarly journals Why is syphilis rising in Europe? Multi-level modelling of alternative hypotheses in 31 countries

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Mendez-Lopez ◽  
D Stuckler ◽  
T Noori ◽  
J C Semenza
Keyword(s):  
Risky Sexual Behavior ◽  
Population Level ◽  
Internet Survey ◽  
Probability Models ◽  
Syphilis Infection ◽  
Detection Rates ◽  
Substantial Impact ◽  
Multi Level ◽  
Sex With Men ◽  
Linear Probability

Abstract Background Syphilis transmission has increased markedly over the past two decades in Europe, concentrated in men who have sex with men. We test alternative potential social and behavioral individual- and population-level determinants of this resurgence. Methods Two rounds of the cross-sectional European Men who have sex with men Internet Survey (EMIS 2010 and 2017, n = 272,902) were used to fit multi-level linear probability models to evaluate determinants of the incidence of self-reported syphilis, capturing risky sexual behaviours and pre-exposure prophylaxis use, among others, adjusting for potential sociodemographic confounders. Results Self-reported syphilis incidence rates rose by about 1.8 percentage points (within the last 12 months) and 3.9 (within the last 5 years) between the 2010 and 2017 waves, after adjusting for sociodemographic factors. HIV status was a major risk factor for syphilis infection (27.6 ppt higher incident rate, 95%CI: 24.7 to 30.5). A dose-response relationship was observed between greater numbers of condomless non-steady partners and syphilis infection, with more than 10 partners estimating increases in the probability of diagnosis of over 25 ppt (11-20 partners vs none: 24.5 ppt, 95%CI: 20.5 to 28.5); further, we observed evidence of mediation for number of condomless non-steady partners, which attenuated the estimated rise in 2017 vs 2010 by about 35%. STI testing uptake also accounted for a substantial increase in syphilis incidence signaling higher detection rates over time. While country-level PrEP use was linked to greater number of condomless partners, there was no substantial impact of population-wide factors, including GDP and PrEP use, on overall syphilis trends. Conclusions Risky sexual behavior changes, particularly condomless sex with non-steady partners, appears to be a major contributing factor to rising syphilis incidence. Further research is needed to understand what accounts for this substantial behavior change. Key messages Increased number of condomless non-steady partners accounts for a substantial rise in syphilis trends. Population-level PrEP use was linked to increasing numbers of condomless non-steady partners but had no substantial impact on overall syphilis trends.

scholarly journals The Prognostic Value of the New Combined Hemo-Eosinophil Inflammation Index (HEI Index): A Multicenter Analysis of Anal Cancer Patients Treated with Concurrent Chemo-Radiation

Cancers ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 671
Author(s):  
Margherita Rimini ◽  
Pierfrancesco Franco ◽  
Berardino De Bari ◽  
Maria Giulia Zampino ◽  
Stefano Vagge ◽  
...  
Keyword(s):  
High Risk ◽  
Cancer Patients ◽  
Anal Cancer ◽  
Prognostic Score ◽  
Univariate Analysis ◽  
External Validation ◽  
Risk Groups ◽  
Anal Squamous Cell Carcinoma ◽  
Predictors Of Response ◽  
Risk Patients

Anal squamous cell carcinoma (SCC) is a rare tumor, and bio-humoral predictors of response to chemo-radiation (CT-RT) are lacking. We developed a prognostic score system based on laboratory inflammation parameters. We investigated the correlation between baseline clinical and laboratory variables and disease-free (DFS) and overall (OS) survival in anal SCC patients treated with CT-RT in five institutions. The bio-humoral parameters of significance were included in a new scoring system, which was tested with other significant variables in a Cox’s proportional hazard model. A total of 308 patients was included. We devised a prognostic model by combining baseline hemoglobin level, SII, and eosinophil count: the Hemo-Eosinophils Inflammation (HEI) Index. We stratified patients according to the HEI index into low- and high-risk groups. Median DFS for low-risk patients was not reached, and it was found to be 79.5 months for high-risk cases (Hazard Ratio 3.22; 95% CI: 2.04–5.10; p < 0.0001). Following adjustment for clinical covariates found significant at univariate analysis, multivariate analysis confirmed the HEI index as an independent prognostic factor for DFS and OS. The HEI index was shown to be a prognostic parameter for DFS and OS in anal cancer patients treated with CT-RT. An external validation of the HEI index is mandatory for its use in clinical practice.

Vroegtijdige opsporing van voorstadia van een anaal carcinoom bij hiv-seropositieve patiënten

2021 ◽  
Author(s):  
E. GÖKCE ◽  
J. GELDOF ◽  
P. ROELANDT ◽  
J. VAN DORPE ◽  
S. CALLENS ◽  
...  
Keyword(s):  
Anal Cancer ◽  
Digital Rectal Examination ◽  
Intraepithelial Neoplasia ◽  
Hpv Infection ◽  
High Grade ◽  
Anal Squamous Cell Carcinoma ◽  
Increased Risk ◽  
High Prevalence ◽  
Risk Patients ◽  
Hiv Seropositive

Early detection of precursor lesions of anal cancer in HIV-seropositive patients Although anal cancer is rare in the overall population, its incidence is increasing in the last decades. Especially HIV-seropositive patients have an increased risk of developing anal squamous cell carcinoma (SCC), mainly because of the high prevalence of high-grade anal intraepithelial neoplasia (AIN) among these patients. High-grade AIN is a precursor lesion for anal SCC associated with human papillomavirus (HPV) infection. Despite the lack of direct evidence demonstrating that AIN identification reduces the risk of anal cancer, experts think that screening and treatment of high-risk patients will prevent the disease. This article aims to review the current literature about AIN and discusses the screening options, including digital rectal examination, anal cytology and high-resolution anoscopy.

scholarly journals Estimation of HIV incidence in two Brazilian municipalities, 2013

2016 ◽  
Vol 50 (0) ◽  
Author(s):  
Célia Landmann Szwarcwald ◽  
Orlando da Costa Ferreira Júnior ◽  
Ana Maria de Brito ◽  
Karin Regina Luhm ◽  
Clea Elisa Lopes Ribeiro ◽  
...  
Keyword(s):  
Total Population ◽  
Hiv Infections ◽  
Incidence Rates ◽  
Hiv Incidence ◽  
Female Ratio ◽  
Exposure Category ◽  
Two Cities ◽  
Population Subgroup ◽  
Sex With Men ◽  
Male To Female

ABSTRACT OBJECTIVE To estimate HIV incidence in two Brazilian municipalities, Recife and Curitiba, in the year of 2013. METHODS The method for estimating incidence was based on primary information, resulting from the Lag-Avidity laboratory test for detection of recent HIV infections, applied in a sample of the cases diagnosed in the two cities in 2013. For the estimation of the HIV incidence for the total population of the cities, the recent infections detected in the research were annualized and weighted by the inverse of the probability of HIV testing in 2013 among the infected and not diagnosed cases. After estimating HIV incidence for the total population, the incidence rates were estimated by sex, age group, and exposure category. RESULTS In Recife, 902 individuals aged 13 years and older were diagnosed with HIV infection. From these, 528 were included in the study, and the estimated proportion of recent infections was 13.1%. In Curitiba, 1,013 people aged 13 years and older were diagnosed, 497 participated in the study, and the proportion of recent infections was 10.5%. In Recife, the estimated incidence rate was 53.1/100,000 inhabitants of 13 years and older, while in Curitiba, it was 41.1/100,000, with male-to-female ratio of 3.5 and 2.4, respectively. We observed high rates of HIV incidence among men who have sex with men, of 1.47% in Recife and 0.92% in Curitiba. CONCLUSIONS The results obtained in the two cities showed that the group of men who have sex with men are disproportionately subject to a greater risk of new infections, and indicate that strategies to control the spread of the epidemic in this population subgroup are essential and urgent.

scholarly journals Implementation of a Rapid Entry Program Decreases Time to Viral Suppression Among Vulnerable Persons Living With HIV in the Southern United States

2018 ◽  
Vol 5 (6) ◽  
Author(s):  
Jonathan Colasanti ◽  
Jeri Sumitani ◽  
C Christina Mehta ◽  
Yiran Zhang ◽  
Minh Ly Nguyen ◽  
...  
Keyword(s):  
United States ◽  
Viral Suppression ◽  
Hiv Transmission ◽  
Positive Impact ◽  
Population Level ◽  
The United States ◽  
Clinic Visit ◽  
Art Initiation ◽  
Persons Living With Hiv ◽  
Sex With Men

Abstract Background Rapid entry programs (REPs) improve time to antiretroviral therapy (ART) initiation (TAI) and time to viral suppression (TVS). We assessed the feasibility and effectiveness of a REP in a large HIV clinic in Atlanta, Georgia, serving a predominately un- or underinsured population. Methods The Rapid Entry and ART in Clinic for HIV (REACH) program was implemented on May 16, 2016. We performed a retrospective cohort study with the main independent variable being period of enrollment: January 1, 2016, through May 15, 2016 (pre-REACH); May 16, 2016, through July 31, 2016 (post-REACH). Included individuals were HIV-infected and new to the clinic with detectable HIV-1 RNA. Six-month follow-up data were collected for each participant. Survival analyses were conducted for TVS. Logistic and linear regression analyses were used to evaluate secondary outcomes: attendance at first clinic visit, viral suppression, TAI, and time to first attended provider visit. Results There were 117 pre-REACH and 90 post-REACH individuals. Median age (interquartile range [IQR]) was 35 (25–45) years, 80% were male, 91% black, 60% men who have sex with men, 57% uninsured, and 44% active substance users. TVS decreased from 77 (62–96) to 57 (41–70) days (P &lt; .0022). Time to first attended provider visit decreased from 17 to 5 days, and TAI from 21 to 7 days (P &lt; .0001), each remaining significant in adjusted models. Conclusions This is the largest rapid entry cohort described in the United States and suggests that rapid entry is feasible and could have a positive impact on HIV transmission at the population level.

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