Gastroenterology Department, Fernando Pessoa Teaching Hospital, Porto, Portugal.
Precancerous Lesions and Early Cancer Management Research Group RISE@CI-IPO [Health Research Network], Portuguese Oncology Institute of Porto [IPO-Porto], Porto, Portugal.
J Crohns Colitis. 2023 Aug 21;17(8):1228-1234. doi: 10.1093/ecco-jcc/jjad045.
Ulcerative colitis [UC] and Crohn's disease [CD] can be associated with severe comorbidities, namely opportunistic infections and malignancies. We present the first systematic review and meta-analysis evaluating the burden of anal human papillomavirus disease in patients with UC and CD.
PubMed, Web of Science, and Scopus were searched until November 2022. Meta-analyses were performed using random effects models. The protocol was recorded at PROSPERO register with the number CRD42022356728.
Six studies, including 78 711 patients with UC with a total follow-up of 518 969 person-years, described the anal cancer incidence rate. For anal cancer incidence rate in CD, six studies were selected, including 56 845 patients with a total follow-up of 671 899 person-years. The incidence of anal cancer was 10.2 [95% CI 4.3 - 23.7] per 100 000 person-years in UC and 7.7 [3.5 - 17.1] per 100 000 person-years in CD. A subgroup analysis of anal cancer in perianal CD, including 7105 patients, was calculated with incidence of 19.6 [12.2 - 31.6] per 100 000 person-years [three studies included]. Few studies described prevalence of anal cytological abnormalities [four studies including 349 patients] or high-risk human papillomavirus [three studies including 210 patients], with high heterogeneity. Prevalence of cytological abnormalities or high-risk human papillomavirus was not associated with pharmacological immunosuppression in the studies included.
The incidence of anal cancer is higher in UC than in CD, with the exception of perianal CD. There are limited and heterogeneous data on anal high-risk human papillomavirus infection and squamous intraepithelial lesions prevalence in this population.
溃疡性结肠炎[UC]和克罗恩病[CD]可伴发严重的合并症，即机会性感染和恶性肿瘤。我们首次进行了系统评价和荟萃分析，评估了 UC 和 CD 患者肛门人乳头瘤病毒疾病的负担。
检索了 PubMed、Web of Science 和 Scopus 数据库，检索截至 2022 年 11 月。采用随机效应模型进行荟萃分析。该方案在 PROSPERO 注册处记录，编号为 CRD42022356728。
纳入了 6 项研究，共纳入 78711 例 UC 患者，总随访时间为 518969 人年，描述了肛门癌的发病率。纳入了 6 项研究评估 CD 中的肛门癌发病率，共纳入 56845 例患者，总随访时间为 671899 人年。UC 患者的肛门癌发病率为 10.2[95%CI 4.3-23.7] /10 万人年，CD 患者的肛门癌发病率为 7.7[3.5-17.1] /10 万人年。对包括 7105 例患者的肛周 CD 中的肛门癌进行亚组分析，发病率为 19.6[12.2-31.6] /10 万人年[包括 3 项研究]。少数研究描述了肛门细胞学异常[包括 349 例患者的 4 项研究]或高危人乳头瘤病毒[包括 210 例患者的 3 项研究]的流行情况，但存在较高的异质性。纳入的研究中，细胞学异常或高危人乳头瘤病毒的流行与药物免疫抑制无关。
UC 患者的肛门癌发病率高于 CD，除肛周 CD 外。该人群中关于肛门高危型人乳头瘤病毒感染和鳞状上皮内病变的流行情况数据有限且存在较大异质性。
