Impact of HIV on Anal Squamous Cell Carcinoma Rates in the United States, 2001-2015.
Impact of HIV on Anal Squamous Cell Carcinoma Rates in the United States, 2001-2015.
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2001-2015 年艾滋病毒对美国肛门鳞状细胞癌发病率的影响。
DOI：
10.1093/jnci/djac103
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Shiels,MeredithS
中科院分区：
文献类型：
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作者：
Zhang,ElizabethR;Pfeiffer,RuthM;Austin,April;Clarke,MeganA;Hayes,Jennifer;Horner,Marie-Josèphe;Monterosso,Analise;Pawlish,KarenS;Engels,EricA;Shiels,MeredithS
背景：在美国，肛门鳞状细胞癌（SCC）的发病率有所上升。艾滋病毒感染者（PLWH）肛门SCC的风险较高，PLWH肛门SCC数量的变化可能影响了总体人群趋势。方法从美国12个地区的艾滋病毒和癌症登记处获得数据。肛门SCCs在PLWH中发生的比例按性别、年龄组、种族和民族进行估计。为了评估PLWH肛门SCCs对一般人群趋势的影响，估计了包括和不包括肛门SCCs的PLWH发病率的年百分比变化（APCs）。结果2001年至2015年，16110例肛门鳞状细胞癌诊断中，14.5%发生在PLWH。2013-2015年，35%的男性肛门SCCs发生在PLWH，而女性只有2%。PLWH中肛门SCCs的比例在20- 49岁、黑人和西班牙裔人群中最高。男性肛门鳞状细胞癌的一般人群趋势受到PLWH肛门鳞状细胞癌的强烈影响：从2001年到2009年，发生率增加了4.6%/年（95%置信区间[CI] = 1.4%至8.0%），随后从2009年到2015年，统计学上无显著下降（APC = - 2.7%/年，95% CI = - 7.1%至2.0%），但没有PLWH肛门鳞状细胞癌，发生率保持稳定（APC = 0.7%/年，95% CI = - 0.8%至2.3%）。2001-2012年间，女性肛门鳞状细胞癌发生率增加3.8%/年（95% CI = 3.2%至4.4%），随后呈无统计学意义的下降（APC = - 3.8%/年，95% CI = - 6.9%至- 0.6%），PLWH的肛门鳞状细胞癌对这些趋势影响不大。结论2001-2015年期间，PLWH肛门SCCs对美国普通人群中男性发病率趋势的变化贡献很大，但对女性没有影响。
BackgroundIncidence of anal squamous cell carcinoma (SCC) has increased in the United States. People living with HIV (PLWH) have an elevated risk of anal SCC, and changes in the number of anal SCCs among PLWH may have influenced general population trends.MethodsData were obtained from a linkage of HIV and cancer registries in 12 US regions. The proportion of anal SCCs occurring among PLWH was estimated by sex, age group, and race and ethnicity. To assess the impact of anal SCCs among PLWH on general population trends, annual percent changes (APCs) in incidence rates including and excluding anal SCCs among PLWH were estimated.ResultsBetween 2001 and 2015, 14.5% of 16 110 anal SCC diagnoses occurred in PLWH. In 2013-2015, 35% of anal SCCs among men occurred in PLWH, but only 2% among women. The proportion of anal SCCs among PLWH was highest among 20- to 49-year-olds and Black and Hispanic individuals. General population anal SCC trends among men were strongly influenced by anal SCCs among PLWH: rates increased 4.6%/y (95% confidence interval [CI] = 1.4% to 8.0%) from 2001 to 2009 followed by a statistically non-significant decline (APC = −2.7%/y, 95% CI = −7.1% to 2.0%) from 2009 to 2015, but without anal SCCs among PLWH, rates were stable (APC = 0.7%/y, 95% CI = −0.8% to 2.3%). Anal SCC rates among women increased 3.8%/y (95% CI = 3.2% to 4.4%) during 2001-2012 and then declined statistically non-significantly (APC = −3.8%/y, 95% CI = −6.9% to −0.6%), and anal SCCs among PLWH had little impact on these trends.ConclusionsDuring 2001-2015, anal SCCs among PLWH contributed strongly to changes in incidence trends in the general US population among men, but not women.