Risk Factors for Anal Cancer in Persons Infected With HIV: A Nested Case-Control Study in the Swiss HIV Cohort Study
Although persons infected with human immunodeficiency virus (HIV), particularly men who have sex with men, are at excess risk for anal cancer, it has been difficult to disentangle the influences of anal exposure to human papillomavirus (HPV) infection, immunodeficiency, and combined antiretroviral t...
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| Veröffentlicht in: | American journal of epidemiology 2013-09, Vol.178 (6), p.877-884 |
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| creator | BERTISCH, Barbara FRANCESCHI, Silvia ESS, Silvia PAWLITA, Michael KOVARI, Helen WANDELER, Gilles CALMY, Alexandra CAVASSINI, Matthias STÖCKLE, Marcel CLIFFORD, Gary LISE, Mauro VERNAZZA, Pietro KEISER, Olivia SCHÖNI-AFFOLTER, Franziska BOUCHARDY, Christine DEHLER, Silvia LEVI, Fabio JUNDT, Gernot |
| description | Although persons infected with human immunodeficiency virus (HIV), particularly men who have sex with men, are at excess risk for anal cancer, it has been difficult to disentangle the influences of anal exposure to human papillomavirus (HPV) infection, immunodeficiency, and combined antiretroviral therapy. A case-control study that included 59 anal cancer cases and 295 individually matched controls was nested in the Swiss HIV Cohort Study (1988-2011). In a subset of 41 cases and 114 controls, HPV antibodies were tested. A majority of anal cancer cases (73%) were men who have sex with men. Current smoking was significantly associated with anal cancer (odds ratio (OR) = 2.59, 95% confidence interval (CI): 1.25, 5.34), as were antibodies against L1 (OR = 4.52, 95% CI: 2.00, 10.20) and E6 (OR = ∞, 95% CI: 4.64, ∞) of HPV16, as well as low CD4+ cell counts, whether measured at nadir (OR per 100-cell/μL decrease = 1.53, 95% CI: 1.18, 2.00) or at cancer diagnosis (OR per 100-cell/μL decrease = 1.24, 95% CI: 1.08, 1.42). However, the influence of CD4+ cell counts appeared to be strongest 6-7 years prior to anal cancer diagnosis (OR for |
| doi_str_mv | 10.1093/aje/kwt153 |
| format | Article |
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A case-control study that included 59 anal cancer cases and 295 individually matched controls was nested in the Swiss HIV Cohort Study (1988-2011). In a subset of 41 cases and 114 controls, HPV antibodies were tested. A majority of anal cancer cases (73%) were men who have sex with men. Current smoking was significantly associated with anal cancer (odds ratio (OR) = 2.59, 95% confidence interval (CI): 1.25, 5.34), as were antibodies against L1 (OR = 4.52, 95% CI: 2.00, 10.20) and E6 (OR = ∞, 95% CI: 4.64, ∞) of HPV16, as well as low CD4+ cell counts, whether measured at nadir (OR per 100-cell/μL decrease = 1.53, 95% CI: 1.18, 2.00) or at cancer diagnosis (OR per 100-cell/μL decrease = 1.24, 95% CI: 1.08, 1.42). However, the influence of CD4+ cell counts appeared to be strongest 6-7 years prior to anal cancer diagnosis (OR for <200 vs. ≥500 cells/μL = 14.0, 95% CI: 3.85, 50.9). Smoking cessation and avoidance of even moderate levels of immunosuppression appear to be important in reducing long-term anal cancer risks.</description><identifier>ISSN: 0002-9262</identifier><identifier>EISSN: 1476-6256</identifier><identifier>DOI: 10.1093/aje/kwt153</identifier><identifier>PMID: 23900553</identifier><identifier>CODEN: AJEPAS</identifier><language>eng</language><publisher>Cary, NC: Oxford University Press</publisher><subject>Adult ; Antiretroviral agents ; Antiretroviral Therapy, Highly Active - adverse effects ; Antiretroviral Therapy, Highly Active - statistics & numerical data ; Anus Neoplasms - epidemiology ; Anus Neoplasms - etiology ; Anus Neoplasms - virology ; Autoimmune diseases ; Biological and medical sciences ; Case-Control Studies ; CD4 Lymphocyte Count ; Clinical outcomes ; Comorbidity ; Epidemiology ; Female ; Gastroenterology. Liver. Pancreas. Abdomen ; General aspects ; HIV ; HIV Infections - complications ; HIV Infections - drug therapy ; HIV Infections - epidemiology ; Homosexuality, Male - statistics & numerical data ; Human immunodeficiency virus ; Human papillomavirus ; Human papillomavirus 16 - isolation & purification ; Human papillomavirus 16 - pathogenicity ; Human viral diseases ; Humans ; Immunocompromised Host ; Incidence ; Infectious diseases ; Male ; Medical sciences ; Middle Aged ; Miscellaneous ; Oncology ; Papillomavirus Infections - complications ; Papillomavirus Infections - transmission ; Papillomavirus Infections - virology ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Risk Factors ; Smoking - adverse effects ; Smoking - epidemiology ; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus ; Substance Abuse, Intravenous - complications ; Switzerland - epidemiology ; Tumors ; Viral diseases ; Viral diseases of the lymphoid tissue and the blood. Aids</subject><ispartof>American journal of epidemiology, 2013-09, Vol.178 (6), p.877-884</ispartof><rights>2014 INIST-CNRS</rights><rights>Copyright Oxford Publishing Limited(England) Sep 15, 2013</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c414t-5ec2a7304a5a19787252ba863d4dfb1d43f3956cee3560d376915b1d9982138f3</citedby><cites>FETCH-LOGICAL-c414t-5ec2a7304a5a19787252ba863d4dfb1d43f3956cee3560d376915b1d9982138f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=27795287$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23900553$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>BERTISCH, Barbara</creatorcontrib><creatorcontrib>FRANCESCHI, Silvia</creatorcontrib><creatorcontrib>ESS, Silvia</creatorcontrib><creatorcontrib>PAWLITA, Michael</creatorcontrib><creatorcontrib>KOVARI, Helen</creatorcontrib><creatorcontrib>WANDELER, Gilles</creatorcontrib><creatorcontrib>CALMY, Alexandra</creatorcontrib><creatorcontrib>CAVASSINI, Matthias</creatorcontrib><creatorcontrib>STÖCKLE, Marcel</creatorcontrib><creatorcontrib>CLIFFORD, Gary</creatorcontrib><creatorcontrib>LISE, Mauro</creatorcontrib><creatorcontrib>VERNAZZA, Pietro</creatorcontrib><creatorcontrib>KEISER, Olivia</creatorcontrib><creatorcontrib>SCHÖNI-AFFOLTER, Franziska</creatorcontrib><creatorcontrib>BOUCHARDY, Christine</creatorcontrib><creatorcontrib>DEHLER, Silvia</creatorcontrib><creatorcontrib>LEVI, Fabio</creatorcontrib><creatorcontrib>JUNDT, Gernot</creatorcontrib><creatorcontrib>Swiss HIV Cohort Study Investigators</creatorcontrib><creatorcontrib>for the Swiss HIV Cohort Study Investigators</creatorcontrib><title>Risk Factors for Anal Cancer in Persons Infected With HIV: A Nested Case-Control Study in the Swiss HIV Cohort Study</title><title>American journal of epidemiology</title><addtitle>Am J Epidemiol</addtitle><description>Although persons infected with human immunodeficiency virus (HIV), particularly men who have sex with men, are at excess risk for anal cancer, it has been difficult to disentangle the influences of anal exposure to human papillomavirus (HPV) infection, immunodeficiency, and combined antiretroviral therapy. A case-control study that included 59 anal cancer cases and 295 individually matched controls was nested in the Swiss HIV Cohort Study (1988-2011). In a subset of 41 cases and 114 controls, HPV antibodies were tested. A majority of anal cancer cases (73%) were men who have sex with men. Current smoking was significantly associated with anal cancer (odds ratio (OR) = 2.59, 95% confidence interval (CI): 1.25, 5.34), as were antibodies against L1 (OR = 4.52, 95% CI: 2.00, 10.20) and E6 (OR = ∞, 95% CI: 4.64, ∞) of HPV16, as well as low CD4+ cell counts, whether measured at nadir (OR per 100-cell/μL decrease = 1.53, 95% CI: 1.18, 2.00) or at cancer diagnosis (OR per 100-cell/μL decrease = 1.24, 95% CI: 1.08, 1.42). However, the influence of CD4+ cell counts appeared to be strongest 6-7 years prior to anal cancer diagnosis (OR for <200 vs. ≥500 cells/μL = 14.0, 95% CI: 3.85, 50.9). Smoking cessation and avoidance of even moderate levels of immunosuppression appear to be important in reducing long-term anal cancer risks.</description><subject>Adult</subject><subject>Antiretroviral agents</subject><subject>Antiretroviral Therapy, Highly Active - adverse effects</subject><subject>Antiretroviral Therapy, Highly Active - statistics & numerical data</subject><subject>Anus Neoplasms - epidemiology</subject><subject>Anus Neoplasms - etiology</subject><subject>Anus Neoplasms - virology</subject><subject>Autoimmune diseases</subject><subject>Biological and medical sciences</subject><subject>Case-Control Studies</subject><subject>CD4 Lymphocyte Count</subject><subject>Clinical outcomes</subject><subject>Comorbidity</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>General aspects</subject><subject>HIV</subject><subject>HIV Infections - complications</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - epidemiology</subject><subject>Homosexuality, Male - statistics & numerical data</subject><subject>Human immunodeficiency virus</subject><subject>Human papillomavirus</subject><subject>Human papillomavirus 16 - isolation & purification</subject><subject>Human papillomavirus 16 - pathogenicity</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Immunocompromised Host</subject><subject>Incidence</subject><subject>Infectious diseases</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Miscellaneous</subject><subject>Oncology</subject><subject>Papillomavirus Infections - complications</subject><subject>Papillomavirus Infections - transmission</subject><subject>Papillomavirus Infections - virology</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Risk Factors</subject><subject>Smoking - adverse effects</subject><subject>Smoking - epidemiology</subject><subject>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</subject><subject>Substance Abuse, Intravenous - complications</subject><subject>Switzerland - epidemiology</subject><subject>Tumors</subject><subject>Viral diseases</subject><subject>Viral diseases of the lymphoid tissue and the blood. Aids</subject><issn>0002-9262</issn><issn>1476-6256</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpd0V1r2zAUBmAxNta03U1_QBGMQSm41bet3gXTj0DpRrutl0aRZeLUsTIdmZJ_XxlnK-xKcPToIN4XoRNKLijR_NKs3eXLa6SSf0AzKnKVKSbVRzQjhLBMM8UO0CHAmhBKtSSf0QHjmhAp-QzFxxZe8I2x0QfAjQ943psOl6a3LuC2xz9cAN8DXvSNs9HV-LmNK3y3-H2F5_jBwTgqDbis9H0MvsNPcah348u4cvjptQUYNS79yoc43R6jT43pwH3Zn0fo1831z_Iuu_9-uyjn95kVVMRMOstMzokw0lCdFzmTbGkKxWtRN0taC95wLZV1jktFap4rTWWaa10wyouGH6Gzae82-D9D-mu1acG6rjO98wNUVKRwhBJCJPr1P7r2Q0hRjEpQorQgMqnzSdngAYJrqm1oNybsKkqqsYsqdVFNXSR8ul85LDeu_kf_hp_Atz0wYE3XhBR6C-8uz7VkRc7fAAn_j2c</recordid><startdate>20130915</startdate><enddate>20130915</enddate><creator>BERTISCH, Barbara</creator><creator>FRANCESCHI, Silvia</creator><creator>ESS, Silvia</creator><creator>PAWLITA, Michael</creator><creator>KOVARI, Helen</creator><creator>WANDELER, Gilles</creator><creator>CALMY, Alexandra</creator><creator>CAVASSINI, Matthias</creator><creator>STÖCKLE, Marcel</creator><creator>CLIFFORD, Gary</creator><creator>LISE, Mauro</creator><creator>VERNAZZA, Pietro</creator><creator>KEISER, Olivia</creator><creator>SCHÖNI-AFFOLTER, Franziska</creator><creator>BOUCHARDY, Christine</creator><creator>DEHLER, Silvia</creator><creator>LEVI, Fabio</creator><creator>JUNDT, Gernot</creator><general>Oxford University Press</general><general>Oxford Publishing Limited (England)</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7T2</scope><scope>7TK</scope><scope>7U7</scope><scope>7U9</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7U1</scope></search><sort><creationdate>20130915</creationdate><title>Risk Factors for Anal Cancer in Persons Infected With HIV: A Nested Case-Control Study in the Swiss HIV Cohort Study</title><author>BERTISCH, Barbara ; FRANCESCHI, Silvia ; ESS, Silvia ; PAWLITA, Michael ; KOVARI, Helen ; WANDELER, Gilles ; CALMY, Alexandra ; CAVASSINI, Matthias ; STÖCKLE, Marcel ; CLIFFORD, Gary ; LISE, Mauro ; VERNAZZA, Pietro ; KEISER, Olivia ; SCHÖNI-AFFOLTER, Franziska ; BOUCHARDY, Christine ; DEHLER, Silvia ; LEVI, Fabio ; JUNDT, Gernot</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c414t-5ec2a7304a5a19787252ba863d4dfb1d43f3956cee3560d376915b1d9982138f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adult</topic><topic>Antiretroviral agents</topic><topic>Antiretroviral Therapy, Highly Active - adverse effects</topic><topic>Antiretroviral Therapy, Highly Active - statistics & numerical data</topic><topic>Anus Neoplasms - epidemiology</topic><topic>Anus Neoplasms - etiology</topic><topic>Anus Neoplasms - virology</topic><topic>Autoimmune diseases</topic><topic>Biological and medical sciences</topic><topic>Case-Control Studies</topic><topic>CD4 Lymphocyte Count</topic><topic>Clinical outcomes</topic><topic>Comorbidity</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>General aspects</topic><topic>HIV</topic><topic>HIV Infections - complications</topic><topic>HIV Infections - drug therapy</topic><topic>HIV Infections - epidemiology</topic><topic>Homosexuality, Male - statistics & numerical data</topic><topic>Human immunodeficiency virus</topic><topic>Human papillomavirus</topic><topic>Human papillomavirus 16 - isolation & purification</topic><topic>Human papillomavirus 16 - pathogenicity</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>Immunocompromised Host</topic><topic>Incidence</topic><topic>Infectious diseases</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Miscellaneous</topic><topic>Oncology</topic><topic>Papillomavirus Infections - complications</topic><topic>Papillomavirus Infections - transmission</topic><topic>Papillomavirus Infections - virology</topic><topic>Public health. Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>Risk Factors</topic><topic>Smoking - adverse effects</topic><topic>Smoking - epidemiology</topic><topic>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</topic><topic>Substance Abuse, Intravenous - complications</topic><topic>Switzerland - epidemiology</topic><topic>Tumors</topic><topic>Viral diseases</topic><topic>Viral diseases of the lymphoid tissue and the blood. Aids</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>BERTISCH, Barbara</creatorcontrib><creatorcontrib>FRANCESCHI, Silvia</creatorcontrib><creatorcontrib>ESS, Silvia</creatorcontrib><creatorcontrib>PAWLITA, Michael</creatorcontrib><creatorcontrib>KOVARI, Helen</creatorcontrib><creatorcontrib>WANDELER, Gilles</creatorcontrib><creatorcontrib>CALMY, Alexandra</creatorcontrib><creatorcontrib>CAVASSINI, Matthias</creatorcontrib><creatorcontrib>STÖCKLE, Marcel</creatorcontrib><creatorcontrib>CLIFFORD, Gary</creatorcontrib><creatorcontrib>LISE, Mauro</creatorcontrib><creatorcontrib>VERNAZZA, Pietro</creatorcontrib><creatorcontrib>KEISER, Olivia</creatorcontrib><creatorcontrib>SCHÖNI-AFFOLTER, Franziska</creatorcontrib><creatorcontrib>BOUCHARDY, Christine</creatorcontrib><creatorcontrib>DEHLER, Silvia</creatorcontrib><creatorcontrib>LEVI, Fabio</creatorcontrib><creatorcontrib>JUNDT, Gernot</creatorcontrib><creatorcontrib>Swiss HIV Cohort Study Investigators</creatorcontrib><creatorcontrib>for the Swiss HIV Cohort Study Investigators</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>Risk Abstracts</collection><jtitle>American journal of epidemiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>BERTISCH, Barbara</au><au>FRANCESCHI, Silvia</au><au>ESS, Silvia</au><au>PAWLITA, Michael</au><au>KOVARI, Helen</au><au>WANDELER, Gilles</au><au>CALMY, Alexandra</au><au>CAVASSINI, Matthias</au><au>STÖCKLE, Marcel</au><au>CLIFFORD, Gary</au><au>LISE, Mauro</au><au>VERNAZZA, Pietro</au><au>KEISER, Olivia</au><au>SCHÖNI-AFFOLTER, Franziska</au><au>BOUCHARDY, Christine</au><au>DEHLER, Silvia</au><au>LEVI, Fabio</au><au>JUNDT, Gernot</au><aucorp>Swiss HIV Cohort Study Investigators</aucorp><aucorp>for the Swiss HIV Cohort Study Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk Factors for Anal Cancer in Persons Infected With HIV: A Nested Case-Control Study in the Swiss HIV Cohort Study</atitle><jtitle>American journal of epidemiology</jtitle><addtitle>Am J Epidemiol</addtitle><date>2013-09-15</date><risdate>2013</risdate><volume>178</volume><issue>6</issue><spage>877</spage><epage>884</epage><pages>877-884</pages><issn>0002-9262</issn><eissn>1476-6256</eissn><coden>AJEPAS</coden><abstract>Although persons infected with human immunodeficiency virus (HIV), particularly men who have sex with men, are at excess risk for anal cancer, it has been difficult to disentangle the influences of anal exposure to human papillomavirus (HPV) infection, immunodeficiency, and combined antiretroviral therapy. A case-control study that included 59 anal cancer cases and 295 individually matched controls was nested in the Swiss HIV Cohort Study (1988-2011). In a subset of 41 cases and 114 controls, HPV antibodies were tested. A majority of anal cancer cases (73%) were men who have sex with men. Current smoking was significantly associated with anal cancer (odds ratio (OR) = 2.59, 95% confidence interval (CI): 1.25, 5.34), as were antibodies against L1 (OR = 4.52, 95% CI: 2.00, 10.20) and E6 (OR = ∞, 95% CI: 4.64, ∞) of HPV16, as well as low CD4+ cell counts, whether measured at nadir (OR per 100-cell/μL decrease = 1.53, 95% CI: 1.18, 2.00) or at cancer diagnosis (OR per 100-cell/μL decrease = 1.24, 95% CI: 1.08, 1.42). However, the influence of CD4+ cell counts appeared to be strongest 6-7 years prior to anal cancer diagnosis (OR for <200 vs. ≥500 cells/μL = 14.0, 95% CI: 3.85, 50.9). Smoking cessation and avoidance of even moderate levels of immunosuppression appear to be important in reducing long-term anal cancer risks.</abstract><cop>Cary, NC</cop><pub>Oxford University Press</pub><pmid>23900553</pmid><doi>10.1093/aje/kwt153</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0002-9262 |
| ispartof | American journal of epidemiology, 2013-09, Vol.178 (6), p.877-884 |
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| language | eng |
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| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Adult Antiretroviral agents Antiretroviral Therapy, Highly Active - adverse effects Antiretroviral Therapy, Highly Active - statistics & numerical data Anus Neoplasms - epidemiology Anus Neoplasms - etiology Anus Neoplasms - virology Autoimmune diseases Biological and medical sciences Case-Control Studies CD4 Lymphocyte Count Clinical outcomes Comorbidity Epidemiology Female Gastroenterology. Liver. Pancreas. Abdomen General aspects HIV HIV Infections - complications HIV Infections - drug therapy HIV Infections - epidemiology Homosexuality, Male - statistics & numerical data Human immunodeficiency virus Human papillomavirus Human papillomavirus 16 - isolation & purification Human papillomavirus 16 - pathogenicity Human viral diseases Humans Immunocompromised Host Incidence Infectious diseases Male Medical sciences Middle Aged Miscellaneous Oncology Papillomavirus Infections - complications Papillomavirus Infections - transmission Papillomavirus Infections - virology Public health. Hygiene Public health. Hygiene-occupational medicine Risk Factors Smoking - adverse effects Smoking - epidemiology Stomach. Duodenum. Small intestine. Colon. Rectum. Anus Substance Abuse, Intravenous - complications Switzerland - epidemiology Tumors Viral diseases Viral diseases of the lymphoid tissue and the blood. Aids |
| title | Risk Factors for Anal Cancer in Persons Infected With HIV: A Nested Case-Control Study in the Swiss HIV Cohort Study |
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