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2020 年全球按性别和 HIV 状况划分的肛门人乳头瘤病毒相关鳞状细胞癌负担:一项全球分析。

Global burden of HPV-attributable squamous cell carcinoma of the anus in 2020, according to sex and HIV status: A worldwide analysis.

机构信息

Center for Health Services Research, Department of Management, Policy, and Community Health, UTHealth School of Public Health, Houston, Texas, USA.

Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France.

出版信息

Int J Cancer. 2023 Feb 1;152(3):417-428. doi: 10.1002/ijc.34269. Epub 2022 Sep 16.

Abstract

Squamous cell carcinoma of the anus (SCCA) is caused by HPV, and is elevated in persons living with HIV (PLWHIV). We aimed to estimate sex- and HIV-stratified SCCA burden at a country, regional and global level. Using anal cancer incidence estimates from 185 countries available through GLOBOCAN 2020, and region/country-specific proportions of SCCA vs non-SCCA from the Cancer Incidence in Five Continents (CI5) Volume XI database, we estimated country- and sex-specific SCCA incidence. Proportions of SCCA diagnosed in PLWHIV, and attributable to HIV, were calculated using estimates of HIV prevalence (UNAIDS 2019) and relative risk applied to SCCA incidence. Of 30 416 SCCA estimated globally in 2020, two-thirds occurred in women (19 792) and one-third among men (10 624). Fifty-three percent of male SCCA and 65% of female SCCA occurred in countries with a very high Human Development Index (HDI). Twenty-one percent of the global male SCCA burden occurred in PLWHIV (n = 2203), largely concentrated in North America, Europe and Africa. While, only 3% of global female SCCA burden (n = 561) occurred in PLWHIV, mainly in Africa. The global age-standardized incidence rate of HIV-negative SCCA was higher in women (0.55 cases per 100 000) than men (0.28), whereas HIV-positive SCCA was higher in men (0.07) than women (0.02). HIV prevalence reached >40% in 22 countries for male SCCA and in 10 countries for female SCCA, mostly in Africa. Understanding global SCCA burden by HIV status can inform SCCA prevention programs (through HPV vaccination, screening and HIV control) and help raise awareness to combat the disease.

摘要

肛门鳞状细胞癌(SCCA)由 HPV 引起,在 HIV 感染者(PLWHIV)中发病率较高。我们旨在评估按性别和 HIV 分层的肛门癌在国家、区域和全球层面的负担。利用 2020 年 GLOBOCAN 提供的 185 个国家的肛门癌发病率估计值,以及来自《癌症发病率五区域》(CI5)第十一卷数据库的各区域/国家 SCCA 与非 SCCA 的比例,我们估计了各国和各性别特有的 SCCA 发病率。通过使用 UNAIDS 2019 年的 HIV 流行率估计值和适用于 SCCA 发病率的相对风险,计算了 PLWHIV 中诊断的 SCCA 比例以及由 HIV 引起的 SCCA 比例。2020 年全球估计有 30416 例 SCCA,其中三分之二发生在女性(19792 例),三分之一发生在男性(10624 例)。53%的男性 SCCA 和 65%的女性 SCCA发生在人类发展指数(HDI)极高的国家。21%的全球男性 SCCA 负担发生在 PLWHIV 中(n=2203),主要集中在北美、欧洲和非洲。而全球女性 SCCA 负担(n=561)中只有 3%发生在 PLWHIV,主要在非洲。HIV 阴性 SCCA 的全球年龄标准化发病率在女性中(每 10 万人中有 0.55 例)高于男性(0.28 例),而 HIV 阳性 SCCA 在男性中(0.07 例)高于女性(0.02 例)。22 个国家的男性 SCCA 和 10 个国家的女性 SCCA的 HIV 流行率达到 40%以上,主要在非洲。了解按 HIV 状况划分的全球 SCCA 负担情况,可以为 SCCA 预防计划(通过 HPV 疫苗接种、筛查和 HIV 控制)提供信息,并有助于提高认识以抗击这种疾病。

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