Incidence and epidemiology of anal cancer in the multicenter AIDS cohort study.

Abstract

OBJECTIVE:

To examine the incidence and risk factors for anal cancer in a multicenter cohort of human immunodeficiency virus (HIV) positive and HIV-negative men who have sex with men followed between 1984 and 2006 (Multicenter AIDS Cohort Study).

METHODS:

Prospective analysis using Poisson regression and Cox proportional hazard models and a nested case-control study using conditional logistic regression.

RESULTS:

There were 28 cases of anal cancer among the 6,972 men who were evaluated. The incidence rate was significantly higher in HIV-positive men than in HIV-negative men (incidence rate = 69 vs 14 per 100,000 person-years). Among HIV-positive men, anal cancer incidence was higher in the highly active antiretroviral therapy (HAART) era than the pre-HAART era (incidence rate = 137 vs 30 per 100,000 person-years). In multivariate analysis restricted to the HAART era, anal cancer risk increased significantly with HIV infection (relative hazard = 4.7, 95% confidence interval = 1.3 to 17) and increasing number of unprotected receptive anal sex partners at the first 3 study visits (P trend = 0.03). Among HIV-positive men, current HAART use did not decrease anal cancer risk.

CONCLUSIONS:

HIV-positive men had increased risk of anal cancer. Improved survival of HIV-positive individuals after HAART initiation may allow for sufficient time for human papillomavirus-associated anal dysplasias to develop into malignancies, thus explaining the increased incidence of anal cancer in the HAART era.

• Authors: Gypsyamber D'Souza, Dorothy J Wiley, Xiuhong Li, Joan S Chmiel, Joseph B Margolick, Ross D Cranston, Lisa P Jacobson
• Journal: Journal of acquired immune deficiency syndromes (1999) (J Acquir Immune Defic Syndr) Vol. 48 Issue 4 Pg. 491-9 (Aug 01 2008) ISSN: 1525-4135 [Print] United States
• PMID: 18614927 (Publication Type: Comparative Study, Journal Article, Research Support, N.I.H., Extramural)

Chemical References

• Anti-HIV Agents

Topics

• Adult
• Anti-HIV Agents (therapeutic use)
• Antiretroviral Therapy, Highly Active
• Anus Neoplasms (complications, epidemiology)
• Carcinoma, Squamous Cell (complications, epidemiology)
• Cohort Studies
• Disease Progression
• HIV
• HIV Infections (complications, drug therapy)
• Homosexuality, Male
• Humans
• Incidence
• Male
• Middle Aged
• Proportional Hazards Models
• Regression Analysis
• Risk Factors
• Unsafe Sex