Cho Ching-Yi, Lo Yu-Cheng, Hung Miao-Chiu, Lai Chou-Cheng, Chen Chun-Jen, Wu Keh-Gong
Department of Pediatrics, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan.
Division of Infectious Diseases, Department of Pediatrics, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan.
PLoS One. 2017 Aug 14;12(8):e0183183. doi: 10.1371/journal.pone.0183183. eCollection 2017.
Condyloma acuminata currently affects around 1% of sexually active adults, and its incidence is increasing. The coexistence of genital warts (GW) and certain cancers and an association between human papillomavirus (HPV) and various malignancies have been reported. Therefore, we conducted this large national study to analyze the risk of malignancies among men and women with GW in Taiwan.
Between January 2000 and December 2013, approximately 3 million patients were reported to the National Health Insurance Research Database of Taiwan. Of these patients, 21,763 were diagnosed with GW. In the same time period, a total of 213,541 cancer cases were reported to the registry, of which 1002 were recorded among patients with GW. The age-specific incidence rates of GW and standardized incidence ratios (SIRs) of malignancies compared to the general population were calculated. Women acquired GW earlier than men, with a mean age at diagnosis of 32.63±12.78 years. The highest incidence rate for both genders peaked at 20-29 years. Of the 1002 patients with GW and malignancies, the SIR was 1.95 (95%CI 1.83-2.07). The most markedly increased risk was found for HPV-related cancers, with a SIR of 9.74 (95%CI 3.70-15.77). Significantly elevated risks were also noted for smoking-related cancers, anogenital cancers, cervix in situ, colon, rectum, lung, kidney, and prostate cancers. Most cancers developed within 10 years after the diagnosis of GW.
Patients with GW have an increased risk of HPV-related cancers, especially anogenital malignancies in Taiwan. The elevated risk of other cancers highlights differences in exposure and risk factors among patients with GW compared to the general population. Cancer screening and HPV vaccination programs should be emphasized for at-risk patients.
尖锐湿疣目前影响着约1%的性活跃成年人，且其发病率正在上升。已有报告指出尖锐湿疣（GW）与某些癌症并存，以及人乳头瘤病毒（HPV）与各种恶性肿瘤之间存在关联。因此，我们开展了这项大型全国性研究，以分析台湾地区患有GW的男性和女性患恶性肿瘤的风险。
2000年1月至2013年12月期间，台湾地区国民健康保险研究数据库共收到约300万例患者报告。其中，21763例被诊断为GW。在同一时期，登记处共报告了213541例癌症病例，其中1002例记录在患有GW的患者中。计算了GW的年龄特异性发病率以及与普通人群相比的恶性肿瘤标准化发病率（SIR）。女性比男性更早感染GW，诊断时的平均年龄为32.63±12.78岁。两性的发病率最高峰值均出现在20 - 29岁。在1002例患有GW和恶性肿瘤的患者中，SIR为1.95（95%CI 1.83 - 2.07）。HPV相关癌症的风险增加最为显著，SIR为9.74（95%CI 3.70 - 15.77）。吸烟相关癌症、肛门生殖器癌症、原位宫颈癌、结肠癌、直肠癌、肺癌、肾癌和前列腺癌的风险也显著升高。大多数癌症在GW诊断后的10年内发生。
在台湾地区，患有GW的患者患HPV相关癌症的风险增加，尤其是肛门生殖器恶性肿瘤。与普通人群相比，GW患者其他癌症风险的升高凸显了其暴露因素和风险因素的差异。应强调对高危患者进行癌症筛查和HPV疫苗接种计划。
