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Age-related prevalence of anal cancer precursors in homosexual men: the EXPLORE study.
J Natl Cancer Inst 2005; 97(12):896-905JNCI

Abstract

BACKGROUND

Infection with human papillomavirus (HPV) is causally linked to the development of anal and cervical cancer. In the United States, the incidence of anal cancer among men who have sex with men (MSM) is higher than the incidence of cervical cancer among women. Anal squamous intraepithelial lesions (ASILs) are anal cancer precursors comprising low-grade squamous intraepithelial lesions (LSILs) and high-grade squamous intraepithelial lesions (HSILs). The prevalence of cervical cancer precursor lesions peaks at around 30 years of age. The age-related prevalence of ASILs in HIV-negative MSM is unknown.

METHODS

We conducted a cross-sectional analysis of the prevalence and determinants of ASILs in 1262 HIV-negative MSM aged 18-89 years recruited from four U.S. cities. Anal cytology and behavioral data were obtained. Anal HPV infection status was assessed by polymerase chain reaction. Independent predictors of ASILs were identified using logistic regression. All statistical tests were two-sided.

RESULTS

The prevalences of LSILs and HSILs were 15% and 5%, respectively, and did not change with age. In a multivariable analysis, the risk of LSILs was associated with having more than five male receptive anal sex partners (P = .03), any use of poppers (alkyl nitrites) in the previous 6 months [odds ratio (OR) = 1.6, 95% confidence interval (CI) = 1.1 to 2.5; P = .03] or use of injection drugs two or more times per month during the previous 6 months [OR = 19, 95% CI = 1.3 to 277; P = .03], older age at first receptive anal intercourse (P = .004), and infection with a greater number of HPV types (P < .001 for linear trend). The risk of HSILs was associated with any anal HPV infection (OR = 3.2, 95% CI = 1.1 to 9.4; P = .039) and infection with an increasing number of HPV types (P < .001 for linear trend).

CONCLUSIONS

Sexually active HIV-negative MSM in all age groups have a high prevalence of ASILs, possibly reflecting their ongoing sexual exposure to HPV.

Authors+Show Affiliations

Department of Medicine, University of California-San Francisco, CA 94143-0654, USA. pvch@itsa.ucsf.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15956651

Citation

Chin-Hong, Peter V., et al. "Age-related Prevalence of Anal Cancer Precursors in Homosexual Men: the EXPLORE Study." Journal of the National Cancer Institute, vol. 97, no. 12, 2005, pp. 896-905.
Chin-Hong PV, Vittinghoff E, Cranston RD, et al. Age-related prevalence of anal cancer precursors in homosexual men: the EXPLORE study. J Natl Cancer Inst. 2005;97(12):896-905.
Chin-Hong, P. V., Vittinghoff, E., Cranston, R. D., Browne, L., Buchbinder, S., Colfax, G., ... Palefsky, J. M. (2005). Age-related prevalence of anal cancer precursors in homosexual men: the EXPLORE study. Journal of the National Cancer Institute, 97(12), pp. 896-905.
Chin-Hong PV, et al. Age-related Prevalence of Anal Cancer Precursors in Homosexual Men: the EXPLORE Study. J Natl Cancer Inst. 2005 Jun 15;97(12):896-905. PubMed PMID: 15956651.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Age-related prevalence of anal cancer precursors in homosexual men: the EXPLORE study. AU - Chin-Hong,Peter V, AU - Vittinghoff,Eric, AU - Cranston,Ross D, AU - Browne,Lynette, AU - Buchbinder,Susan, AU - Colfax,Grant, AU - Da Costa,Maria, AU - Darragh,Teresa, AU - Benet,Dana Jones, AU - Judson,Franklyn, AU - Koblin,Beryl, AU - Mayer,Kenneth H, AU - Palefsky,Joel M, PY - 2005/6/16/pubmed PY - 2005/7/13/medline PY - 2005/6/16/entrez SP - 896 EP - 905 JF - Journal of the National Cancer Institute JO - J. Natl. Cancer Inst. VL - 97 IS - 12 N2 - BACKGROUND: Infection with human papillomavirus (HPV) is causally linked to the development of anal and cervical cancer. In the United States, the incidence of anal cancer among men who have sex with men (MSM) is higher than the incidence of cervical cancer among women. Anal squamous intraepithelial lesions (ASILs) are anal cancer precursors comprising low-grade squamous intraepithelial lesions (LSILs) and high-grade squamous intraepithelial lesions (HSILs). The prevalence of cervical cancer precursor lesions peaks at around 30 years of age. The age-related prevalence of ASILs in HIV-negative MSM is unknown. METHODS: We conducted a cross-sectional analysis of the prevalence and determinants of ASILs in 1262 HIV-negative MSM aged 18-89 years recruited from four U.S. cities. Anal cytology and behavioral data were obtained. Anal HPV infection status was assessed by polymerase chain reaction. Independent predictors of ASILs were identified using logistic regression. All statistical tests were two-sided. RESULTS: The prevalences of LSILs and HSILs were 15% and 5%, respectively, and did not change with age. In a multivariable analysis, the risk of LSILs was associated with having more than five male receptive anal sex partners (P = .03), any use of poppers (alkyl nitrites) in the previous 6 months [odds ratio (OR) = 1.6, 95% confidence interval (CI) = 1.1 to 2.5; P = .03] or use of injection drugs two or more times per month during the previous 6 months [OR = 19, 95% CI = 1.3 to 277; P = .03], older age at first receptive anal intercourse (P = .004), and infection with a greater number of HPV types (P < .001 for linear trend). The risk of HSILs was associated with any anal HPV infection (OR = 3.2, 95% CI = 1.1 to 9.4; P = .039) and infection with an increasing number of HPV types (P < .001 for linear trend). CONCLUSIONS: Sexually active HIV-negative MSM in all age groups have a high prevalence of ASILs, possibly reflecting their ongoing sexual exposure to HPV. SN - 1460-2105 UR - https://www.unboundmedicine.com/medline/citation/15956651/Age_related_prevalence_of_anal_cancer_precursors_in_homosexual_men:_the_EXPLORE_study_ L2 - https://academic.oup.com/jnci/article-lookup/doi/10.1093/jnci/dji163 DB - PRIME DP - Unbound Medicine ER -