National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Sydney, NSW 2010, Australia.
Vaccine. 2011 Mar 9;29(12):2322-7. doi: 10.1016/j.vaccine.2011.01.015. Epub 2011 Jan 19.
Most anal squamous cell carcinomas (SCCs) are caused by high risk types of human papillomavirus (HPV) and are potentially preventable by HPV vaccination. In order to understand the burden of potentially preventable anal cancer in Australia, we examine the incidence and survival from invasive anal SCC 1982-2005.
We reviewed data on invasive anal cancer cases notified to the National Cancer Statistics Clearing House. Age specific incidence rates of SCC were calculated by year of cancer diagnosis and by birth cohort, and rates of anal adenocarcinoma were included for comparison. Incidence rates were age standardised to the Australian 2001 standard population. Trends in relative survival of SCC were examined.
During the study period, a total of 4615 invasive anal cancer cases were diagnosed and most (69.7%) were SCC. Annual incidence of SCC increased almost 50%, from 0.65 to 1.00/100,000. Incidence increased at all ages. The annual rate of increase was almost two-folder higher in men (3.42%, 95% CI 2.49-4.35) than in women (1.88%, 95% CI 1.18-2.58). Five-year relative survival increased by nearly 10% from 58.9% to 68.3% over the last 20 years. Younger patients and women had better survival. For anal adenocarcinoma, increases of borderline significance were seen in men and women.
There is an increasing burden of anal SCC in Australia. The group with the highest incidence - homosexual men - are not likely to be protected under the current vaccination policy.
大多数肛门鳞状细胞癌（SCC）是由高危型人乳头瘤病毒（HPV）引起的，可通过 HPV 疫苗接种预防。为了了解澳大利亚潜在可预防的肛门癌负担，我们研究了 1982-2005 年侵袭性肛门 SCC 的发病率和生存率。
我们回顾了国家癌症统计数据交换所报告的侵袭性肛门癌病例的数据。按癌症诊断年份和出生队列计算 SCC 的特定年龄发病率，并包括肛门腺癌的发病率进行比较。发病率按澳大利亚 2001 年标准人口进行年龄标准化。检查 SCC 相对生存率的趋势。
在研究期间，共诊断出 4615 例侵袭性肛门癌病例，其中大多数（69.7%）为 SCC。SCC 的年发病率几乎增加了 50%，从 0.65 增至 1.00/100,000。所有年龄段的发病率均有所增加。男性的年增长率几乎是女性的两倍（3.42%，95%CI 2.49-4.35）。过去 20 年，5 年相对生存率从 58.9%提高到 68.3%，提高了近 10%。年轻患者和女性的生存率更高。对于肛门腺癌，男性和女性的发病率均有上升趋势，但无统计学意义。
澳大利亚肛门 SCC 的负担不断增加。发病率最高的群体——同性恋男性——不太可能受到当前疫苗接种政策的保护。
