Risk of anal cancer in HIV-infected and HIV-uninfected individuals in North America

Michael J. Silverberg, Bryan M Lau, Amy C. Justice, Eric Engels, M. John Gill, James J. Goedert, Gregory D Kirk, Gypsyamber D'Souza, Ronald J. Bosch, John T. Brooks, Sonia Napravnik, Nancy A. Hessol, Lisa Paula Jacobson, Mari M. Kitahata, Marina B. Klein, Richard D Moore, Benigno Rodriguez, Sean B. Rourke, Michael S. Saag, Timothy R. Sterling & 4 others Kelly Gebo, Natasha Press, Jeffrey N. Martin, Robert Dubrow

Research output: Contribution to journalArticle

Abstract

Background. Anal cancer is one of the most common cancers affecting individuals infected with human immunodeficiency virus (HIV), although few have evaluated rates separately for men who have sex with men (MSM), other men, and women. There are also conflicting data regarding calendar trends. Methods. In a study involving 13 cohorts from North America with follow-up between 1996 and 2007, we compared anal cancer incidence rates among 34189 HIV-infected (55% MSM, 19% other men, 26% women) and 114260 HIV-uninfected individuals (90% men).Results.Among men, the unadjusted anal cancer incidence rates per 100000 person-years were 131 for HIV-infected MSM, 46 for other HIV-infected men, and 2 for HIV-uninfected men, corresponding to demographically adjusted rate ratios (RRs) of 80.3 (95% confidence interval [CI], 42.7-151.1) for HIV-infected MSM and 26.7 (95% CI, 11.5-61.7) for other HIV-infected men compared with HIV-uninfected men. HIV-infected women had an anal cancer rate of 30/100000 person-years, and no cases were observed for HIV-uninfected women. In a multivariable Poisson regression model, among HIV-infected individuals, the risk was higher for MSM compared with other men (RR, 3.3; 95% CI, 1.8-6.0), but no difference was observed comparing women with other men (RR, 1.0; 95% CI, 0.5-2.2). In comparison with the period 2000-2003, HIV-infected individuals had an adjusted RR of 0.5 (95% CI,. 3-.9) in 1996-1999 and 0.9 (95% CI,. 6-1.2) in 2004-2007. Conclusions. Anal cancer rates were substantially higher for HIV-infected MSM, other men, and women compared with HIV-uninfected individuals, suggesting a need for universal prevention efforts. Rates increased after the early antiretroviral therapy era and then plateaued.

Original languageEnglish (US)
Pages (from-to)1026-1034
Number of pages9
JournalClinical Infectious Diseases
Volume54
Issue number7
DOIs
StatePublished - Apr 1 2012

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Anus Neoplasms
North America
HIV
Confidence Intervals
HIV-2
Incidence
Secondary Prevention

ASJC Scopus subject areas

  • Infectious Diseases
  • Microbiology (medical)

Cite this

Silverberg, M. J., Lau, B. M., Justice, A. C., Engels, E., Gill, M. J., Goedert, J. J., ... Dubrow, R. (2012). Risk of anal cancer in HIV-infected and HIV-uninfected individuals in North America. Clinical Infectious Diseases, 54(7), 1026-1034. https://doi.org/10.1093/cid/cir1012

Risk of anal cancer in HIV-infected and HIV-uninfected individuals in North America. / Silverberg, Michael J.; Lau, Bryan M; Justice, Amy C.; Engels, Eric; Gill, M. John; Goedert, James J.; Kirk, Gregory D; D'Souza, Gypsyamber; Bosch, Ronald J.; Brooks, John T.; Napravnik, Sonia; Hessol, Nancy A.; Jacobson, Lisa Paula; Kitahata, Mari M.; Klein, Marina B.; Moore, Richard D; Rodriguez, Benigno; Rourke, Sean B.; Saag, Michael S.; Sterling, Timothy R.; Gebo, Kelly; Press, Natasha; Martin, Jeffrey N.; Dubrow, Robert.

In: Clinical Infectious Diseases, Vol. 54, No. 7, 01.04.2012, p. 1026-1034.

Research output: Contribution to journalArticle

Silverberg, MJ, Lau, BM, Justice, AC, Engels, E, Gill, MJ, Goedert, JJ, Kirk, GD, D'Souza, G, Bosch, RJ, Brooks, JT, Napravnik, S, Hessol, NA, Jacobson, LP, Kitahata, MM, Klein, MB, Moore, RD, Rodriguez, B, Rourke, SB, Saag, MS, Sterling, TR, Gebo, K, Press, N, Martin, JN & Dubrow, R 2012, 'Risk of anal cancer in HIV-infected and HIV-uninfected individuals in North America', Clinical Infectious Diseases, vol. 54, no. 7, pp. 1026-1034. https://doi.org/10.1093/cid/cir1012
Silverberg, Michael J. ; Lau, Bryan M ; Justice, Amy C. ; Engels, Eric ; Gill, M. John ; Goedert, James J. ; Kirk, Gregory D ; D'Souza, Gypsyamber ; Bosch, Ronald J. ; Brooks, John T. ; Napravnik, Sonia ; Hessol, Nancy A. ; Jacobson, Lisa Paula ; Kitahata, Mari M. ; Klein, Marina B. ; Moore, Richard D ; Rodriguez, Benigno ; Rourke, Sean B. ; Saag, Michael S. ; Sterling, Timothy R. ; Gebo, Kelly ; Press, Natasha ; Martin, Jeffrey N. ; Dubrow, Robert. / Risk of anal cancer in HIV-infected and HIV-uninfected individuals in North America. In: Clinical Infectious Diseases. 2012 ; Vol. 54, No. 7. pp. 1026-1034.
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abstract = "Background. Anal cancer is one of the most common cancers affecting individuals infected with human immunodeficiency virus (HIV), although few have evaluated rates separately for men who have sex with men (MSM), other men, and women. There are also conflicting data regarding calendar trends. Methods. In a study involving 13 cohorts from North America with follow-up between 1996 and 2007, we compared anal cancer incidence rates among 34189 HIV-infected (55{\%} MSM, 19{\%} other men, 26{\%} women) and 114260 HIV-uninfected individuals (90{\%} men).Results.Among men, the unadjusted anal cancer incidence rates per 100000 person-years were 131 for HIV-infected MSM, 46 for other HIV-infected men, and 2 for HIV-uninfected men, corresponding to demographically adjusted rate ratios (RRs) of 80.3 (95{\%} confidence interval [CI], 42.7-151.1) for HIV-infected MSM and 26.7 (95{\%} CI, 11.5-61.7) for other HIV-infected men compared with HIV-uninfected men. HIV-infected women had an anal cancer rate of 30/100000 person-years, and no cases were observed for HIV-uninfected women. In a multivariable Poisson regression model, among HIV-infected individuals, the risk was higher for MSM compared with other men (RR, 3.3; 95{\%} CI, 1.8-6.0), but no difference was observed comparing women with other men (RR, 1.0; 95{\%} CI, 0.5-2.2). In comparison with the period 2000-2003, HIV-infected individuals had an adjusted RR of 0.5 (95{\%} CI,. 3-.9) in 1996-1999 and 0.9 (95{\%} CI,. 6-1.2) in 2004-2007. Conclusions. Anal cancer rates were substantially higher for HIV-infected MSM, other men, and women compared with HIV-uninfected individuals, suggesting a need for universal prevention efforts. Rates increased after the early antiretroviral therapy era and then plateaued.",
author = "Silverberg, {Michael J.} and Lau, {Bryan M} and Justice, {Amy C.} and Eric Engels and Gill, {M. John} and Goedert, {James J.} and Kirk, {Gregory D} and Gypsyamber D'Souza and Bosch, {Ronald J.} and Brooks, {John T.} and Sonia Napravnik and Hessol, {Nancy A.} and Jacobson, {Lisa Paula} and Kitahata, {Mari M.} and Klein, {Marina B.} and Moore, {Richard D} and Benigno Rodriguez and Rourke, {Sean B.} and Saag, {Michael S.} and Sterling, {Timothy R.} and Kelly Gebo and Natasha Press and Martin, {Jeffrey N.} and Robert Dubrow",
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T1 - Risk of anal cancer in HIV-infected and HIV-uninfected individuals in North America

AU - Silverberg, Michael J.

AU - Lau, Bryan M

AU - Justice, Amy C.

AU - Engels, Eric

AU - Gill, M. John

AU - Goedert, James J.

AU - Kirk, Gregory D

AU - D'Souza, Gypsyamber

AU - Bosch, Ronald J.

AU - Brooks, John T.

AU - Napravnik, Sonia

AU - Hessol, Nancy A.

AU - Jacobson, Lisa Paula

AU - Kitahata, Mari M.

AU - Klein, Marina B.

AU - Moore, Richard D

AU - Rodriguez, Benigno

AU - Rourke, Sean B.

AU - Saag, Michael S.

AU - Sterling, Timothy R.

AU - Gebo, Kelly

AU - Press, Natasha

AU - Martin, Jeffrey N.

AU - Dubrow, Robert

PY - 2012/4/1

Y1 - 2012/4/1

N2 - Background. Anal cancer is one of the most common cancers affecting individuals infected with human immunodeficiency virus (HIV), although few have evaluated rates separately for men who have sex with men (MSM), other men, and women. There are also conflicting data regarding calendar trends. Methods. In a study involving 13 cohorts from North America with follow-up between 1996 and 2007, we compared anal cancer incidence rates among 34189 HIV-infected (55% MSM, 19% other men, 26% women) and 114260 HIV-uninfected individuals (90% men).Results.Among men, the unadjusted anal cancer incidence rates per 100000 person-years were 131 for HIV-infected MSM, 46 for other HIV-infected men, and 2 for HIV-uninfected men, corresponding to demographically adjusted rate ratios (RRs) of 80.3 (95% confidence interval [CI], 42.7-151.1) for HIV-infected MSM and 26.7 (95% CI, 11.5-61.7) for other HIV-infected men compared with HIV-uninfected men. HIV-infected women had an anal cancer rate of 30/100000 person-years, and no cases were observed for HIV-uninfected women. In a multivariable Poisson regression model, among HIV-infected individuals, the risk was higher for MSM compared with other men (RR, 3.3; 95% CI, 1.8-6.0), but no difference was observed comparing women with other men (RR, 1.0; 95% CI, 0.5-2.2). In comparison with the period 2000-2003, HIV-infected individuals had an adjusted RR of 0.5 (95% CI,. 3-.9) in 1996-1999 and 0.9 (95% CI,. 6-1.2) in 2004-2007. Conclusions. Anal cancer rates were substantially higher for HIV-infected MSM, other men, and women compared with HIV-uninfected individuals, suggesting a need for universal prevention efforts. Rates increased after the early antiretroviral therapy era and then plateaued.

AB - Background. Anal cancer is one of the most common cancers affecting individuals infected with human immunodeficiency virus (HIV), although few have evaluated rates separately for men who have sex with men (MSM), other men, and women. There are also conflicting data regarding calendar trends. Methods. In a study involving 13 cohorts from North America with follow-up between 1996 and 2007, we compared anal cancer incidence rates among 34189 HIV-infected (55% MSM, 19% other men, 26% women) and 114260 HIV-uninfected individuals (90% men).Results.Among men, the unadjusted anal cancer incidence rates per 100000 person-years were 131 for HIV-infected MSM, 46 for other HIV-infected men, and 2 for HIV-uninfected men, corresponding to demographically adjusted rate ratios (RRs) of 80.3 (95% confidence interval [CI], 42.7-151.1) for HIV-infected MSM and 26.7 (95% CI, 11.5-61.7) for other HIV-infected men compared with HIV-uninfected men. HIV-infected women had an anal cancer rate of 30/100000 person-years, and no cases were observed for HIV-uninfected women. In a multivariable Poisson regression model, among HIV-infected individuals, the risk was higher for MSM compared with other men (RR, 3.3; 95% CI, 1.8-6.0), but no difference was observed comparing women with other men (RR, 1.0; 95% CI, 0.5-2.2). In comparison with the period 2000-2003, HIV-infected individuals had an adjusted RR of 0.5 (95% CI,. 3-.9) in 1996-1999 and 0.9 (95% CI,. 6-1.2) in 2004-2007. Conclusions. Anal cancer rates were substantially higher for HIV-infected MSM, other men, and women compared with HIV-uninfected individuals, suggesting a need for universal prevention efforts. Rates increased after the early antiretroviral therapy era and then plateaued.

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