北美 HIV 感染者罹患肛门癌的最新和预测发病趋势及风险。

IF 9.9 1区 医学 Q1 ONCOLOGY JNCI Journal of the National Cancer Institute Pub Date : 2024-09-01 DOI:10.1093/jnci/djae096
Ashish A Deshmukh, Yueh-Yun Lin, Haluk Damgacioglu, Meredith Shiels, Sally B Coburn, Raynell Lang, Keri N Althoff, Richard Moore, Michael J Silverberg, Alan G Nyitray, Jagpreet Chhatwal, Kalyani Sonawane, Keith Sigel
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引用次数: 0

摘要

背景:艾滋病病毒感染者(PWH)患肛门癌的风险较高。近期美国和加拿大艾滋病感染者的肛门癌发病模式仍不清楚。目前还不清楚未来几年的发病模式会如何演变:利用北美艾滋病队列研究与设计合作组织的数据,我们调查了美国、加拿大和美国不同地区的肛门癌绝对发病率和发病趋势。我们进一步估算了与未感染艾滋病毒者相比的相对风险、不同亚群之间的相对风险,并预测了美国艾滋病感染者未来的肛门癌负担:2001-2016年间,美国的年龄标准化肛门癌发病率每年下降2.2%(95%CI=-4.4%至-0.1%),尤其是西部地区(-3.8%/年[95%CI=-6.5%至-0.9%])。加拿大的发病率保持稳定。美国各地区的风险存在很大的地域差异(例如,在感染艾滋病毒的男男性行为者中,中西部和东南部的风险是东北部的四倍以上)。罹患肛门癌的风险随着 CD4 细胞计数的下降而增加,并在机会性疾病患者中升高。预计未来几年(到 2035 年)美国肛门癌发病率将有所下降,但 70% 以上的病例仍将发生在感染 HIV 的 MSM 和艾滋病患者中:结论:肛门癌风险和趋势的地域差异可能反映了筛查方法和艾滋病流行的潜在差异。感染艾滋病毒的男男性行为者和艾滋病患者将继续承担大部分肛门癌负担,这凸显了精准预防的重要性。
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Recent and projected incidence trends and risk of anal cancer among people with HIV in North America.

Background: Anal cancer risk is elevated among people with HIV. Recent anal cancer incidence patterns among people with HIV in the United States and Canada remain unclear. It is unknown how the incidence patterns may evolve.

Methods: Using data from the North American AIDS Cohort Collaboration on Research and Design, we investigated absolute anal cancer incidence and incidence trends nationally in the United States and Canada and in different US regions. We further estimated relative risk compared with people without HIV, relative risk among various subgroups, and projected future anal cancer burden among American people with HIV.

Results: Between 2001 and 2016 in the United States, age-standardized anal cancer incidence declined 2.2% per year (95% confidence interval = ‒4.4% to ‒0.1%), particularly in the Western region (‒3.8% per year, 95% confidence interval = ‒6.5% to ‒0.9%). In Canada, incidence remained stable. Considerable geographic variation in risk was observed by US regions (eg, more than 4-fold risk in the Midwest and Southeast compared with the Northeast among men who have sex with men who have HIV). Anal cancer risk increased with a decrease in nadir CD4 cell count and was elevated among those individuals with opportunistic illnesses. Anal cancer burden among American people with HIV is expected to decrease through 2035, but more than 70% of cases will continue to occur in men who have sex with men who have HIV and in people with AIDS.

Conclusion: Geographic variation in anal cancer risk and trends may reflect underlying differences in screening practices and HIV epidemic. Men who have sex with men who have HIV and people with prior AIDS diagnoses will continue to bear the highest anal cancer burden, highlighting the importance of precision prevention.

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来源期刊
CiteScore
17.00
自引率
2.90%
发文量
203
审稿时长
4-8 weeks
期刊介绍: The Journal of the National Cancer Institute is a reputable publication that undergoes a peer-review process. It is available in both print (ISSN: 0027-8874) and online (ISSN: 1460-2105) formats, with 12 issues released annually. The journal's primary aim is to disseminate innovative and important discoveries in the field of cancer research, with specific emphasis on clinical, epidemiologic, behavioral, and health outcomes studies. Authors are encouraged to submit reviews, minireviews, and commentaries. The journal ensures that submitted manuscripts undergo a rigorous and expedited review to publish scientifically and medically significant findings in a timely manner.
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