Changing Patterns of Anal Canal Carcinoma in the United States
Top Cited Papers
- 20 April 2013
- journal article
- research article
- Published by American Society of Clinical Oncology (ASCO) in Journal of Clinical Oncology
- Vol. 31 (12), 1569-1575
- https://doi.org/10.1200/jco.2012.45.2524
Abstract
Purpose Persistent human papillomavirus infection is associated with squamous cell carcinoma of the anal canal (SCCA). With changing sexual behaviors, SCCA incidence and patient demographics may also have changed in recent years. Methods The Surveillance, Epidemiology, and End Results public-use data set from 1973 to 2009 was analyzed to determine incidence trends for and demographic factors characterizing SCCA. Joinpoint analyses identified time points when incidence rates changed. For comparison, similar analyses were conducted for anal adenocarcinoma. Results Joinpoint analyses identified 1997 as the single inflection point among 11,231 patients with SCCA, at which the slope of incidence rates statistically increased (1997 to 2009 v 1973 to 1996: risk ratio [RR], 2.2; 95% CI, 2.1 to 2.3). Annual percent change (APC) increased for all SCCA stages and was the greatest for anal carcinoma in situ (CIS; APC, 14.2; 95% CI, 10.2 to 18.4). Demographic changes characterizing later versus earlier time period included younger age at diagnosis and rising incidence rates in all stage, sex, and racial groups. During 1997 to 2009, women were less likely to present with CIS (RR, 0.3; 95% CI, 0.3 to 0.3) but more likely to present with localized (RR, 1.2; 95% CI, 1.1 to 1.3) and regional SCCA (RR, 1.5; 95% CI, 1.4 to 1.7). In contrast, adenocarcinoma APCs among 1,791 patients remained stable during this time period. Conclusion CIS and SCCA incidence increased dramatically after 1997 for men and women, although men were more likely to be diagnosed with CIS. These changes likely resulted from available screening in men and argue for efforts to identify high-risk individuals who may benefit from screening.This publication has 35 references indexed in Scilit:
- Efficient interval estimation for age-adjusted cancer ratesStatistical Methods in Medical Research, 2006
- A Population-Based Analysis of Temporal Trends in the Incidence of Squamous Anal Canal Cancer in Relation to the HIV EpidemicJAIDS Journal of Acquired Immune Deficiency Syndromes, 2005
- Anal cancer incidence and survival: The Surveillance, Epidemiology, and End Results experience, 1973–2000Cancer, 2004
- Evolution of Cervical Abnormalities Among Women With HIV-1: Evidence From Surveillance Cytology in the Women's Interagency HIV StudyJAIDS Journal of Acquired Immune Deficiency Syndromes, 2001
- Prevalence and Risk Factors for Anal Squamous Intraepithelial Lesions in WomenJNCI Journal of the National Cancer Institute, 2001
- Prevalence and Risk Factors for Anal Human Papillomavirus Infection in Human Immunodeficiency Virus (HIV)–Positive and High‐Risk HIV‐Negative WomenThe Journal of Infectious Diseases, 2001
- Natural History of Cervicovaginal Papillomavirus Infection in Young WomenThe New England Journal of Medicine, 1998
- Prevalence and Risk Factors for Human Papillomavirus Infection of the Anal Canal in Human Immunodeficiency Virus (HIV)‐Positive and HIV‐Negative Homosexual MenThe Journal of Infectious Diseases, 1998
- The role of human papillomaviruses in anogenital cancers.Seminars in Cancer Biology, 1998
- Anal human papillomavirus and anal cancer.Journal of Clinical Pathology, 1997