期刊
CLINICAL INFECTIOUS DISEASES
卷 72, 期 5, 页码 853-861出版社
OXFORD UNIV PRESS INC
DOI: 10.1093/cid/ciaa166
关键词
anal cancer; HPV; high grade squamous intraepithelial lesions; incidence; gay and bisexual men
资金
- National Health and Medical Research Council Program Grant (Sexually Transmitted Infections: causes, consequences and interventions grant) [568971]
- Cancer Council New South Wales Strategic Research Partnership Program Grant (Preventing morbidity and mortality from anal cancer grant) [13-11]
- Australian Government of Health and Ageing
This study found that factors such as younger age, HIV positivity, and persistent HPV16 infection were associated with a higher incidence of high-grade squamous intraepithelial lesions (HSIL). On the other hand, factors like younger age, smaller lesions, and absence of persistent HPV16 infection were associated with a higher clearance rate of HSIL.
Background. Gay and bisexual men (GBM) are disproportionately affected by anal cancer. Prevention is hindered by incomplete understanding of the natural history of its precursor, anal high-grade squamous intraepithelial lesions (HSIL). Methods. The Study of the Prevention of Anal Cancer, conducted between 2010 and 2018, enrolled human immunodeficiency virus (HIV)-positive and HIV-negative GBM aged >= 35 years. Anal cytology and high-resolution anoscopy (HRA) were performed at baseline and 3 annual visits. A composite HSIL diagnosis (cytology +/- histology) was used. Cytological high-grade squamous intraepithelial lesions (cIISIL) incidence and clearance rates were calculated with 95% confidence intervals (CIs). Predictors were calculated using Cox regression with hazard ratios (HRs) and 95% CIs. Results. Among 617 men, 220 (35.7%) were HIV-positive, median age 49 years. And 124 incident cHSIL cases occurred over 1097.3 person-years (PY) follow-up (11.3, 95% CI 9.5-13.5 per 100 PY). Significant bivariate predictors of higher incidence included age <45 years (HR 1.64, 95% CI 1.11-2.41), HIV positivity (HR 1.43, 95% CI .99-2.06), prior SIL diagnosis (P-trend < .001) and human papillomavirus (HPV)16 (HR 3.39, 2.38-4.84). Over 695.3 PY follow-up, 153 HSIL deared (clearance 22.0, 95% CI 18.8-25.8 per 100 PY). Predictors were age <45 years (HR 1.52, 1.08-2.16), anal intraepithelial neoplasia (AIN)2 rather than AIN3 (HR 1.79, 1.29-2.49), smaller lesions (HR 1.62, 1.11-2.36) and no persistent HPV16 (HR 1.72,1.23-2.41). There was 1 progression to cancer (incidence 0.224,95% CI .006-1.25 per 100 PY). Conclusion. These data strongly suggest that not all anal HSIL detected in screening requires treatment. Men with persistent HPV16 were less likely to clear HSIL and are more likely to benefit from effective HSIL treatments.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据