A new explanation for rising rates of anal cancer
Background: Anal intraepithelial neoplasia (AIN) is associated with high-risk human papillomavirus (hrHPV) infection and is a precursor to anal cancer. Factors other than hrHPV are likely to be involved in causing AIN and further study of cofactors is required. Methods: A surgical database of patien...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2018-06-01
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| Series: | Papillomavirus Research |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405852118300715 |
| _version_ | 1819049716710637568 |
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| author | Jenny McCloskey W. Martin Kast James P. Flexman Dugald McCallum Martyn A. French Michael Phillips |
| author_facet | Jenny McCloskey W. Martin Kast James P. Flexman Dugald McCallum Martyn A. French Michael Phillips |
| author_sort | Jenny McCloskey |
| collection | DOAJ |
| description | Background: Anal intraepithelial neoplasia (AIN) is associated with high-risk human papillomavirus (hrHPV) infection and is a precursor to anal cancer. Factors other than hrHPV are likely to be involved in causing AIN and further study of cofactors is required. Methods: A surgical database of patients having anal warts removed was established at Royal Perth Hospital in 1995 and epidemiological information concerning age, sex, sexual preference, history or clinical evidence of gonorrhoea or chlamydia infection and serological evidence of HIV-1, HSV-2, hepatitis B or C virus infection and syphilis has been prospectively collected since then. Three hundred and fourteen patients underwent 457 operations from June 1995 to November 2016. Histopathology and hrHPV testing using the Digene Hybrid Capture 2 (HC2) method were performed at the time of surgery. Results: hrHPV alone was associated with high-grade squamous epithelial lesions (HSIL) (OR=4.65, p<0.001). Amplification of HSIL risk was found when hrHPV infection occurred with HIV-1 (OR=11.1) or HSV-2 (OR=7.85) infection; current or previous gonorrhoea (OR=6.45) or syphilis (OR=5.58); and some other infections. Conclusions: HrHPV is a sufficient cause of anal HSIL but seropositivity for HIV-1, HSV-2, T. pallidum, HBV, HCV infections and a history of gonorrhoea or chlamydia exert a powerful amplifying factor increasing the risk of HSIL above the risk with hrHPV alone. This pattern of disease in patients with warts is characteristic of a syndemic with potential increased risk of anal carcinoma in men because of rising rates of sexually-transmitted infections. |
| first_indexed | 2024-12-21T11:36:35Z |
| format | Article |
| id | doaj.art-c2c4c10722ea4381a3ad9ae25dd82972 |
| institution | Directory Open Access Journal |
| issn | 2405-8521 |
| language | English |
| last_indexed | 2024-12-21T11:36:35Z |
| publishDate | 2018-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Papillomavirus Research |
| spelling | doaj.art-c2c4c10722ea4381a3ad9ae25dd829722022-12-21T19:05:25ZengElsevierPapillomavirus Research2405-85212018-06-015S10A new explanation for rising rates of anal cancerJenny McCloskey0W. Martin Kast1James P. Flexman2Dugald McCallum3Martyn A. French4Michael Phillips5Sexual Health Services, Royal Perth Hospital; School of Medicine and Pharmacology, University of Western Australia, Perth, WA 6000, AustraliaDepartments of Molecular Microbiology & Immunology and Obstetrics & Gynaecology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA 90033, USADepartment of Microbiology and Infectious Diseases, Royal Perth Hospital; PathWest Laboratory Medicine, WA, Australia; Departments of Microbiology and Immunology and Pathology and Laboratory Medicine, University of Western Australia, Crawley, Western Australia 6009, AustraliaDepartment of Anatomical Pathology, PathWest Laboratory Medicine (WA), Barry Marshall Drive, Murdoch, WA 6150, AustraliaUWA Medical School and School of Biomedical Sciences, University of Western Australia, Perth, AustraliaHarry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, Australia; Centre for Medical Research, The University of Western Australia, Crawley, Western Australia 6009, AustraliaBackground: Anal intraepithelial neoplasia (AIN) is associated with high-risk human papillomavirus (hrHPV) infection and is a precursor to anal cancer. Factors other than hrHPV are likely to be involved in causing AIN and further study of cofactors is required. Methods: A surgical database of patients having anal warts removed was established at Royal Perth Hospital in 1995 and epidemiological information concerning age, sex, sexual preference, history or clinical evidence of gonorrhoea or chlamydia infection and serological evidence of HIV-1, HSV-2, hepatitis B or C virus infection and syphilis has been prospectively collected since then. Three hundred and fourteen patients underwent 457 operations from June 1995 to November 2016. Histopathology and hrHPV testing using the Digene Hybrid Capture 2 (HC2) method were performed at the time of surgery. Results: hrHPV alone was associated with high-grade squamous epithelial lesions (HSIL) (OR=4.65, p<0.001). Amplification of HSIL risk was found when hrHPV infection occurred with HIV-1 (OR=11.1) or HSV-2 (OR=7.85) infection; current or previous gonorrhoea (OR=6.45) or syphilis (OR=5.58); and some other infections. Conclusions: HrHPV is a sufficient cause of anal HSIL but seropositivity for HIV-1, HSV-2, T. pallidum, HBV, HCV infections and a history of gonorrhoea or chlamydia exert a powerful amplifying factor increasing the risk of HSIL above the risk with hrHPV alone. This pattern of disease in patients with warts is characteristic of a syndemic with potential increased risk of anal carcinoma in men because of rising rates of sexually-transmitted infections.http://www.sciencedirect.com/science/article/pii/S2405852118300715 |
| spellingShingle | Jenny McCloskey W. Martin Kast James P. Flexman Dugald McCallum Martyn A. French Michael Phillips A new explanation for rising rates of anal cancer Papillomavirus Research |
| title | A new explanation for rising rates of anal cancer |
| title_full | A new explanation for rising rates of anal cancer |
| title_fullStr | A new explanation for rising rates of anal cancer |
| title_full_unstemmed | A new explanation for rising rates of anal cancer |
| title_short | A new explanation for rising rates of anal cancer |
| title_sort | new explanation for rising rates of anal cancer |
| url | http://www.sciencedirect.com/science/article/pii/S2405852118300715 |
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