The epidemiology of anal cancer
The epidemiology of anal cancer
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DOI：
10.1071/sh12070
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发表时间：
2012-01-01
期刊：
影响因子：
1.6
通讯作者：
Hillman, Richard J.
中科院分区：
文献类型：
--
作者：
Grulich, Andrew E.;Poynten, I. Mary;Hillman, Richard J.
肛门癌主要包括两种形态变异的肛管恶性肿瘤：鳞状细胞癌（SCC）和腺癌。在大多数情况下，SCC 会影响 70% 以上的情况。在一般人群中，肛门癌并不常见，年龄标准化发病率大多在每年每 10 万人中 1 至 2 例之间。然而，在发达国家，肛门 SCC 的发病率每年以 1-3% 的速度增加。 80-90% 的肛门鳞状细胞癌病例中可检测到高危型人乳头瘤病毒 (HPV)，使其与该病毒的关联性仅次于宫颈癌。与 90% 的 HPV 阳性肛门鳞状细胞癌病例类似，可检测到 HPV-16。病例对照研究表明，性危险因素（男性同性恋和女性多性伴侣）与肛门癌风险密切相关。其他危险因素包括免疫缺陷和烟草暴露。男性同性恋者的肛门癌发病率最高，尤其是艾滋病毒呈阳性的男性，肛门癌是所有癌症中最常见的一种。对于尚未感染 HPV 的人来说，接种 HPV 疫苗对于预防肛门癌有很大希望。对于当前这一代成人高危人群，正在研究能够及早发现和治疗的筛查计划。
Anal cancer comprises malignancies of the anal canal principally of two morphologic variants: squamous cell carcinoma (SCC) and adenocarcinoma. In most settings, SCC compromises more than 70% of cases. In the general population, anal cancer is uncommon, with age-standardised incidence rates mostly between 1 and 2 per 100 000 per year. However, incidence of anal SCC is increasing by 1-3% per year in developed country settings. High-risk human papillomavirus (HPV) types can be detected in 80-90% of all anal SCC cases, making it second only to cervical cancer in the closeness of its association with this virus. HPV-16 can be detected in similar to 90% of HPV-positive cases of anal SCC. Case-control studies have demonstrated that sexual risk factors (homosexuality in men and multiple sexual partners in women) are strongly associated with anal cancer risk. Other risk factors include immune deficiency and tobacco exposure. Anal cancer rates are highest in homosexual men, particularly in those who are HIV-positive, in whom anal cancer is among the most common of all cancers. Vaccination against HPV holds great promise for anal cancer prevention for those not already HPV-infected. For the current generation of adult high-risk populations, screening programs to allow early detection and treatment are under investigation.