Department of Medicine, McGill University, Montreal, QC.
Division of Dermatology, University of Ottawa, Ottawa, ON.
Curr Oncol. 2020 Jun;27(3):e294-e306. doi: 10.3747/co.27.6061. Epub 2020 Jun 1.
Anal cancer is a rare disease, constituting 0.5% of new cancer cases in the United States. The most common subtype is squamous cell carcinoma (scc). Studies in several developed nations have reported on an increasing incidence of anal cancer in recent decades, and various risk factors pertaining to the pathogenesis of the disease have been identified, including infection with the human papillomavirus, tobacco use, and immunosuppression. The epidemiology and distribution of anal scc throughout Canada remain poorly understood, however.
Using 3 population-based cancer registries, a retrospective analysis of demographic data across Canada for 1992-2010 was performed. The incidence and mortality for anal scc was examined at the levels of provinces, cities, and the forward sortation area (FSA) component (first 3 characters) of postal codes.
During 1992-2010, 3720 individuals were diagnosed with anal scc in Canada; 64% were women. The overall national incidence rate was 6.3 cases per million population per year, with an average age at diagnosis of 60.4 years. The incidence increased over time, with significantly higher incidence rates documented in British Columbia and Nova Scotia (9.3 cases per million population each). Closer examination revealed clustering of cases in various urban centres and self-identified lgbtq communities in Toronto, Montreal, and Vancouver.
This study provides, for the first time, a comprehensive analysis of the burden of anal scc in Canada, identifying susceptible populations and shedding light onto novel avenues of research to lower the incidence of anal cancer throughout the country.
肛门癌是一种罕见的疾病，占美国新发癌症病例的 0.5%。最常见的亚型是鳞状细胞癌（scc）。几个发达国家的研究报告称，近几十年来肛门癌的发病率有所上升，并且已经确定了与疾病发病机制相关的各种危险因素，包括人乳头瘤病毒感染、吸烟和免疫抑制。然而，加拿大的肛门 scc 的流行病学和分布仍知之甚少。
使用 3 个基于人群的癌症登记处，对 1992 年至 2010 年加拿大各地的人口统计学数据进行了回顾性分析。检查了省级、市级和邮政编码的前向分类区域（FSA）部分（前 3 个字符）的肛门 scc 的发病率和死亡率。
1992 年至 2010 年间，加拿大有 3720 人被诊断患有肛门 scc；其中 64%为女性。全国总体发病率为每年每百万人口 6.3 例，平均诊断年龄为 60.4 岁。发病率随时间推移而增加，不列颠哥伦比亚省和新斯科舍省的发病率明显更高（分别为每百万人口 9.3 例）。进一步检查显示，在多伦多、蒙特利尔和温哥华的各个城市中心和自我认同的 lgbtq 社区存在病例聚集。
这项研究首次对加拿大肛门 scc 的负担进行了全面分析，确定了易感人群，并为降低全国范围内肛门癌的发病率提供了新的研究途径。
