TY - JOUR
T1 - Risk of anal cancer in HIV-infected and HIV-uninfected individuals in North America
AU - Silverberg, Michael J.
AU - Lau, Bryan
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 P.
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 A.
AU - Press, Natasha
AU - Martin, Jeffrey N.
AU - Dubrow, Robert
N1 - Funding Information:
Potential conflicts of interest. M. J. S. received research grant support from Pfizer and Merck. G. D. K. has been a consultant to GlaxoSmithKline and Merck. G. D. has been a consultant to and received research grant support from Merck. M. B. K. has been a consultant to GlaxoSmithKline, Abbott, Pfizer, and Boehringer-Ingelheim, has received lecture fees from Abbott, Gilead, Tibotec, Bristol-Myers Squibb, and GlaxoSmithKline, and received research support from Schering Plough Canada. R. D. M. has been a consultant to Bristol-Myers Squibb and Merck. T. R. S. received research grant support from Pfizer and Bristol-Myers Squibb. All other authors report no potential conflicts.
Funding Information:
Financial support. This work was supported by grants from the National Institutes of Health: U01-AI069918, U01-AA013566, U01-AI-35042, 5-M01-RR-00052 (General Clinical Research Centers [GCRC]), U01-AI-35043, U01-AI-35039, U01-AI-35040, U01-AI-35041, U01-AI38855: AIDS Clinical Trials Group Longitudinal Linked Randomized Trials (ALLRT); U01-AI38858; U01-AI68634; U01-AI68636; AI-69432; AI-69434, U01-AI-35004, U01-AI-31834, U01-AI-34994, U01-AI-34989, U01-AI-34993, and U01-AI-42590, U01-HD-32632, UL1-RR024131, P30-AI27757; K23-AI-61-0320, P30-AI27767, P30-AI50410; RR025747, P30-AI54999, R01-DA04334; R01-DA12568, R01-MH54907, R24-AI067039, N02-CP55504; Z01-CP010176, AHQ290-01-0012, K01-AI071754, K24-00432; R01-DA11602, K01-AI071725, R01 AG026250, and P30 AI027763. This work was also supported by the Canadian Institutes for Health Research (CIHR: TGF-96118; HCP-97105; CBR-86906; CBR-94036; KRS-86251; 169621) and the Canadian Trials Network (project 242). Finally, support was also provided by the Centers for Disease Control (CDC200-2006-18797); the findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.
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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U2 - 10.1093/cid/cir1012
DO - 10.1093/cid/cir1012
M3 - Article
C2 - 22291097
AN - SCOPUS:84863254376
SN - 1058-4838
VL - 54
SP - 1026
EP - 1034
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 7
ER -