2001-2015 年美国 HIV 对肛门鳞癌发病率的影响。
Impact of HIV on Anal Squamous Cell Carcinoma Rates in the United States, 2001-2015.
机构信息
Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA.
New York Department of Health, New York State Cancer Registry, Albany, NY, USA.
出版信息
J Natl Cancer Inst. 2022 Sep 9;114(9):1246-1252. doi: 10.1093/jnci/djac103.
BACKGROUND
Incidence of anal squamous cell carcinoma (SCC) has increased in the United States. People living with HIV (PLWH) have an elevated risk of anal SCC, and changes in the number of anal SCCs among PLWH may have influenced general population trends.
METHODS
Data were obtained from a linkage of HIV and cancer registries in 12 US regions. The proportion of anal SCCs occurring among PLWH was estimated by sex, age group, and race and ethnicity. To assess the impact of anal SCCs among PLWH on general population trends, annual percent changes (APCs) in incidence rates including and excluding anal SCCs among PLWH were estimated.
RESULTS
Between 2001 and 2015, 14.5% of 16 110 anal SCC diagnoses occurred in PLWH. In 2013-2015, 35% of anal SCCs among men occurred in PLWH, but only 2% among women. The proportion of anal SCCs among PLWH was highest among 20- to 49-year-olds and Black and Hispanic individuals. General population anal SCC trends among men were strongly influenced by anal SCCs among PLWH: rates increased 4.6%/y (95% confidence interval [CI] = 1.4% to 8.0%) from 2001 to 2009 followed by a statistically non-significant decline (APC = -2.7%/y, 95% CI = -7.1% to 2.0%) from 2009 to 2015, but without anal SCCs among PLWH, rates were stable (APC = 0.7%/y, 95% CI = -0.8% to 2.3%). Anal SCC rates among women increased 3.8%/y (95% CI = 3.2% to 4.4%) during 2001-2012 and then declined statistically non-significantly (APC = -3.8%/y, 95% CI = -6.9% to -0.6%), and anal SCCs among PLWH had little impact on these trends.
CONCLUSIONS
During 2001-2015, anal SCCs among PLWH contributed strongly to changes in incidence trends in the general US population among men, but not women.
背景
在美国，肛门鳞状细胞癌（SCC）的发病率有所上升。感染艾滋病毒（HIV）的人群（PLWH）肛门 SCC 的风险较高，PLWH 中肛门 SCC 数量的变化可能会影响一般人群的趋势。
方法
数据来自美国 12 个地区的 HIV 和癌症登记处的链接。按性别、年龄组和种族和族裔估计发生在 PLWH 中的肛门 SCC 比例。为了评估 PLWH 中肛门 SCC 对一般人群趋势的影响，估计了包括和不包括 PLWH 中肛门 SCC 在内的发病率的年百分比变化（APC）。
结果
2001 年至 2015 年间，16110 例肛门 SCC 诊断中有 14.5%发生在 PLWH 中。2013 年至 2015 年，男性肛门 SCC 中有 35%发生在 PLWH 中，但女性仅占 2%。PLWH 中肛门 SCC 的比例在 20 至 49 岁和黑人和西班牙裔人群中最高。男性人群中肛门 SCC 的总体流行趋势受到 PLWH 中肛门 SCC 的强烈影响：发病率从 2001 年至 2009 年以每年 4.6%的速度增长（95%置信区间 [CI] = 1.4%至 8.0%），随后在 2009 年至 2015 年期间出现统计学上无显著下降（APC = -2.7%/y，95%CI = -7.1%至 2.0%），但如果不包括 PLWH 中的肛门 SCC，发病率保持稳定（APC = 0.7%/y，95%CI = -0.8%至 2.3%）。女性的肛门 SCC 发病率在 2001 年至 2012 年间以每年 3.8%的速度增长（95%CI = 3.2%至 4.4%），随后统计学上呈非显著下降（APC = -3.8%/y，95%CI = -6.9%至 -0.6%），PLWH 中的肛门 SCC 对这些趋势影响不大。
结论
2001 年至 2015 年间，PLWH 中的肛门 SCC 对美国男性人群发病率趋势的变化有很大影响，但对女性没有影响。
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