Anal cancer risk among people with HIV infection in the United States

Vivian Colón-López, Meredith S. Shiels, Mark Machin, Ana P. Ortiz, Howard Strickler, Philip E. Castle, Ruth M. Pfeiffer, Eric A. Engels

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Purpose People with HIV infection have an elevated risk of anal cancer. However, recent calendar trends are incompletely described, and which population subgroupsmight benefit from cancer screening is unknown. Methods We used linked data from HIV and cancer registries in nine US areas (1996 to 2012). We calculated standardized incidence ratios to compare anal cancer incidence in people with HIV infection with the general population, used Poisson regression to evaluate anal cancer incidence among subgroups of people with HIV and to assess temporal trends, and estimated the cumulative incidence of anal cancer to measure absolute risk. Results Among 447,953 people with HIV infection, anal cancer incidence was much higher than in the general population (standardized incidence ratio, 19.1; 95% CI, 18.1 to 20.0). Anal cancer incidence was highest among men who have sex with men (MSM), increased with age, and was higher in people with AIDS than in those without AIDS (ie, HIV only; adjusted incidence rate ratio, 3.82; 95% CI, 3.27 to 4.46). Incidence among people with HIV increased steeply during 1996 to 2000 (annual percentage change, 32.8%; 95% CI, 21.0% to 78.2%), reached a plateau during 2001 to 2008, and declined during 2008 to 2012 (annual percentage change, 27.2%; 95% CI, 214.4% to 0.6%). Cumulative incidence after a 5-year period was high for MSM with HIV only age 45 to 59 or ≥ 60 years (0.32% to 0.33%) and MSM with AIDS age 30 to 44, 45 to 59, or≥60 years (0.29% to 0.65%). Conclusion Anal cancer incidence is markedly elevated among people with HIV infection, especially in MSM, older individuals, and people with AIDS. Recent declines may reflect delayed benefits of HIV treatment. Groups with high cumulative incidence of anal cancer may benefit from screening.

Original languageEnglish (US)
Pages (from-to)68-75
Number of pages8
JournalJournal of Clinical Oncology
Volume36
Issue number1
DOIs
StatePublished - Jan 1 2018

Fingerprint

Anus Neoplasms
HIV Infections
Incidence
HIV
Acquired Immunodeficiency Syndrome
Population
Early Detection of Cancer
Registries

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Anal cancer risk among people with HIV infection in the United States. / Colón-López, Vivian; Shiels, Meredith S.; Machin, Mark; Ortiz, Ana P.; Strickler, Howard; Castle, Philip E.; Pfeiffer, Ruth M.; Engels, Eric A.

In: Journal of Clinical Oncology, Vol. 36, No. 1, 01.01.2018, p. 68-75.

Research output: Contribution to journalArticle

Colón-López, V, Shiels, MS, Machin, M, Ortiz, AP, Strickler, H, Castle, PE, Pfeiffer, RM & Engels, EA 2018, 'Anal cancer risk among people with HIV infection in the United States', Journal of Clinical Oncology, vol. 36, no. 1, pp. 68-75. https://doi.org/10.1200/JCO.2017.74.9291
Colón-López, Vivian ; Shiels, Meredith S. ; Machin, Mark ; Ortiz, Ana P. ; Strickler, Howard ; Castle, Philip E. ; Pfeiffer, Ruth M. ; Engels, Eric A. / Anal cancer risk among people with HIV infection in the United States. In: Journal of Clinical Oncology. 2018 ; Vol. 36, No. 1. pp. 68-75.
@article{7edd583ce4e04f778cb32614e42c2d22,
title = "Anal cancer risk among people with HIV infection in the United States",
abstract = "Purpose People with HIV infection have an elevated risk of anal cancer. However, recent calendar trends are incompletely described, and which population subgroupsmight benefit from cancer screening is unknown. Methods We used linked data from HIV and cancer registries in nine US areas (1996 to 2012). We calculated standardized incidence ratios to compare anal cancer incidence in people with HIV infection with the general population, used Poisson regression to evaluate anal cancer incidence among subgroups of people with HIV and to assess temporal trends, and estimated the cumulative incidence of anal cancer to measure absolute risk. Results Among 447,953 people with HIV infection, anal cancer incidence was much higher than in the general population (standardized incidence ratio, 19.1; 95{\%} CI, 18.1 to 20.0). Anal cancer incidence was highest among men who have sex with men (MSM), increased with age, and was higher in people with AIDS than in those without AIDS (ie, HIV only; adjusted incidence rate ratio, 3.82; 95{\%} CI, 3.27 to 4.46). Incidence among people with HIV increased steeply during 1996 to 2000 (annual percentage change, 32.8{\%}; 95{\%} CI, 21.0{\%} to 78.2{\%}), reached a plateau during 2001 to 2008, and declined during 2008 to 2012 (annual percentage change, 27.2{\%}; 95{\%} CI, 214.4{\%} to 0.6{\%}). Cumulative incidence after a 5-year period was high for MSM with HIV only age 45 to 59 or ≥ 60 years (0.32{\%} to 0.33{\%}) and MSM with AIDS age 30 to 44, 45 to 59, or≥60 years (0.29{\%} to 0.65{\%}). Conclusion Anal cancer incidence is markedly elevated among people with HIV infection, especially in MSM, older individuals, and people with AIDS. Recent declines may reflect delayed benefits of HIV treatment. Groups with high cumulative incidence of anal cancer may benefit from screening.",
author = "Vivian Col{\'o}n-L{\'o}pez and Shiels, {Meredith S.} and Mark Machin and Ortiz, {Ana P.} and Howard Strickler and Castle, {Philip E.} and Pfeiffer, {Ruth M.} and Engels, {Eric A.}",
year = "2018",
month = "1",
day = "1",
doi = "10.1200/JCO.2017.74.9291",
language = "English (US)",
volume = "36",
pages = "68--75",
journal = "Journal of Clinical Oncology",
issn = "0732-183X",
publisher = "American Society of Clinical Oncology",
number = "1",

}

TY - JOUR

T1 - Anal cancer risk among people with HIV infection in the United States

AU - Colón-López, Vivian

AU - Shiels, Meredith S.

AU - Machin, Mark

AU - Ortiz, Ana P.

AU - Strickler, Howard

AU - Castle, Philip E.

AU - Pfeiffer, Ruth M.

AU - Engels, Eric A.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Purpose People with HIV infection have an elevated risk of anal cancer. However, recent calendar trends are incompletely described, and which population subgroupsmight benefit from cancer screening is unknown. Methods We used linked data from HIV and cancer registries in nine US areas (1996 to 2012). We calculated standardized incidence ratios to compare anal cancer incidence in people with HIV infection with the general population, used Poisson regression to evaluate anal cancer incidence among subgroups of people with HIV and to assess temporal trends, and estimated the cumulative incidence of anal cancer to measure absolute risk. Results Among 447,953 people with HIV infection, anal cancer incidence was much higher than in the general population (standardized incidence ratio, 19.1; 95% CI, 18.1 to 20.0). Anal cancer incidence was highest among men who have sex with men (MSM), increased with age, and was higher in people with AIDS than in those without AIDS (ie, HIV only; adjusted incidence rate ratio, 3.82; 95% CI, 3.27 to 4.46). Incidence among people with HIV increased steeply during 1996 to 2000 (annual percentage change, 32.8%; 95% CI, 21.0% to 78.2%), reached a plateau during 2001 to 2008, and declined during 2008 to 2012 (annual percentage change, 27.2%; 95% CI, 214.4% to 0.6%). Cumulative incidence after a 5-year period was high for MSM with HIV only age 45 to 59 or ≥ 60 years (0.32% to 0.33%) and MSM with AIDS age 30 to 44, 45 to 59, or≥60 years (0.29% to 0.65%). Conclusion Anal cancer incidence is markedly elevated among people with HIV infection, especially in MSM, older individuals, and people with AIDS. Recent declines may reflect delayed benefits of HIV treatment. Groups with high cumulative incidence of anal cancer may benefit from screening.

AB - Purpose People with HIV infection have an elevated risk of anal cancer. However, recent calendar trends are incompletely described, and which population subgroupsmight benefit from cancer screening is unknown. Methods We used linked data from HIV and cancer registries in nine US areas (1996 to 2012). We calculated standardized incidence ratios to compare anal cancer incidence in people with HIV infection with the general population, used Poisson regression to evaluate anal cancer incidence among subgroups of people with HIV and to assess temporal trends, and estimated the cumulative incidence of anal cancer to measure absolute risk. Results Among 447,953 people with HIV infection, anal cancer incidence was much higher than in the general population (standardized incidence ratio, 19.1; 95% CI, 18.1 to 20.0). Anal cancer incidence was highest among men who have sex with men (MSM), increased with age, and was higher in people with AIDS than in those without AIDS (ie, HIV only; adjusted incidence rate ratio, 3.82; 95% CI, 3.27 to 4.46). Incidence among people with HIV increased steeply during 1996 to 2000 (annual percentage change, 32.8%; 95% CI, 21.0% to 78.2%), reached a plateau during 2001 to 2008, and declined during 2008 to 2012 (annual percentage change, 27.2%; 95% CI, 214.4% to 0.6%). Cumulative incidence after a 5-year period was high for MSM with HIV only age 45 to 59 or ≥ 60 years (0.32% to 0.33%) and MSM with AIDS age 30 to 44, 45 to 59, or≥60 years (0.29% to 0.65%). Conclusion Anal cancer incidence is markedly elevated among people with HIV infection, especially in MSM, older individuals, and people with AIDS. Recent declines may reflect delayed benefits of HIV treatment. Groups with high cumulative incidence of anal cancer may benefit from screening.

UR - http://www.scopus.com/inward/record.url?scp=85039919078&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85039919078&partnerID=8YFLogxK

U2 - 10.1200/JCO.2017.74.9291

DO - 10.1200/JCO.2017.74.9291

M3 - Article

VL - 36

SP - 68

EP - 75

JO - Journal of Clinical Oncology

JF - Journal of Clinical Oncology

SN - 0732-183X

IS - 1

ER -