State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University, Xiamen, Fujian, China.
Liuzhou Center for Disease Control and Prevention, Liuzhou, Guangxi, China.
Int J Cancer. 2019 Aug 1;145(3):807-816. doi: 10.1002/ijc.32255. Epub 2019 Mar 22.
Anal cancer is primarily caused by human papillomavirus (HPV) infection in both men and women. However, little is known about the sex differences in the natural history of anal HPV infection in a heterosexual population. From May 2014 to March 2016, perianal/anal canal (PA) swab samples were collected semiannually from 2,302 heterosexual men and 2,371 heterosexual women aged 18-55 years old in Liuzhou, China. The specimens were genotyped for HPV DNA by polymerase chain reaction. The incidence rate ratio (IRR) and clearance rate ratio (CRR) were used to analyze the sex differences of incidence and clearance by Poisson regression, respectively. The incidences of PA oncogenic HPV in men and women were 3.4 per 1,000 person-months and 8.6 per 1,000 person-months, respectively, with an IRR of 0.39 (95% confidence interval (CI), 0.29-0.54 for men versus women) (p < 0.0001). The CRR of PA oncogenic HPV infection for men versus women was 1.54 (95% CI, 1.17-2.03) (p = 0.0022). At 12 months, 44% (20/45) of HPV 16/18 infections among women remained positive, whereas no (0/7) infections persisted among men (p = 0.0350). Both the higher incidence and slower clearance of anal carcinogenic HPV infection among women may lead to a higher burden of anal cancer among women than among men in a heterosexual population.
肛门癌主要由男性和女性的人乳头瘤病毒（HPV）感染引起。然而，对于异性恋人群中肛门 HPV 感染的自然史中的性别差异知之甚少。2014 年 5 月至 2016 年 3 月，从中国柳州市 18-55 岁的 2302 名异性恋男性和 2371 名异性恋女性中每半年采集一次肛周/肛门管（PA）拭子样本。采用聚合酶链反应（PCR）对 HPV DNA 进行基因分型。应用泊松回归分别分析发病率比（IRR）和清除率比（CRR），以分析发病率和清除率的性别差异。男性和女性 PA 致癌 HPV 的发病率分别为每 1000 人-月 3.4 例和 8.6 例，IRR 为 0.39（95%置信区间（CI），0.29-0.54，男性与女性相比）（p<0.0001）。男性与女性 PA 致癌 HPV 感染的 CRR 为 1.54（95%CI，1.17-2.03）（p=0.0022）。在 12 个月时，女性中 44%（20/45）的 HPV16/18 感染仍为阳性，而男性中无一例（0/7）感染持续存在（p=0.0350）。女性肛门致癌 HPV 感染的发病率较高和清除率较慢，可能导致异性恋人群中女性肛门癌的负担高于男性。
