Grulich Andrew E, Poynten I Mary, Machalek Dorothy A, Jin Fengyi, Templeton David J, Hillman Richard J
University of New South Wales, Sydney, NSW 2052, Australia.
Sex Health. 2012 Dec;9(6):504-8. doi: 10.1071/SH12070.
Anal cancer comprises malignancies of the anal canal principally of two morphologic variants: squamous cell carcinoma (SCC) and adenocarcinoma. In most settings, SCC compromises more than 70% of cases. In the general population, anal cancer is uncommon, with age-standardised incidence rates mostly between 1 and 2 per 100000 per year. However, incidence of anal SCC is increasing by 1-3% per year in developed country settings. High-risk human papillomavirus (HPV) types can be detected in 80-90% of all anal SCC cases, making it second only to cervical cancer in the closeness of its association with this virus. HPV-16 can be detected in ~90% of HPV-positive cases of anal SCC. Case-control studies have demonstrated that sexual risk factors (homosexuality in men and multiple sexual partners in women) are strongly associated with anal cancer risk. Other risk factors include immune deficiency and tobacco exposure. Anal cancer rates are highest in homosexual men, particularly in those who are HIV-positive, in whom anal cancer is among the most common of all cancers. Vaccination against HPV holds great promise for anal cancer prevention for those not already HPV-infected. For the current generation of adult high-risk populations, screening programs to allow early detection and treatment are under investigation.
鳞状细胞癌（SCC）和腺癌。在大多数情况下，SCC占病例的70%以上。在一般人群中，肛管癌并不常见，年龄标准化发病率大多在每年每10万人中1至2例之间。然而，在发达国家，肛管鳞状细胞癌的发病率每年以1%至3%的速度增长。在所有肛管鳞状细胞癌病例中，80%至90%可检测到高危型人乳头瘤病毒（HPV），这使其与该病毒的关联紧密程度仅次于宫颈癌。在约90%的HPV阳性肛管鳞状细胞癌病例中可检测到HPV - 16。病例对照研究表明，性风险因素（男性同性恋和女性多个性伴侣）与肛管癌风险密切相关。其他风险因素包括免疫缺陷和接触烟草。肛管癌发病率在男同性恋者中最高，尤其是那些感染了艾滋病毒的人，在他们当中肛管癌是所有癌症中最常见的癌症之一。对于尚未感染HPV的人来说，接种HPV疫苗对预防肛管癌具有很大的前景。对于当代成年高危人群，正在研究能够实现早期检测和治疗的筛查项目。
