Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Oct 19;13(10):e0205105.
doi: 10.1371/journal.pone.0205105. eCollection 2018.

Anal cancer in high-income countries: Increasing burden of disease

Yoon-Jung Kang  1 , Megan Smith  1 , Karen Canfell  1   2   3
Affiliations

Anal cancer in high-income countries: Increasing burden of disease

Yoon-Jung Kang et al. PLoS One. .

Erratum in

Abstract

Background: Previous studies have reported that anal cancer incidence has increased in individual countries; however, age-specific trends were not examined in detail. This study describes pooled and country-specific anal cancer incidence trends by sex, age (all ages, <60 and 60+ years) and histological subtype (all subtypes, squamous cell carcinoma [SCC] and adenocarcinoma [ADC]).

Methods: Five-year incidence and population-at-risk data were obtained from IARC's Cancer Incidence in Five Continents for the years 1988-1992 to 2008-2012. The standardised rate ratios (SRRs) for 2008-2012 vs 1988-1992 and the 5-year average percent change (AvPC) during the period were used to assess changes in the age-standardised incidence rates.

Results: During the study period, there were significant increases in the incidence of SCC in both men and women of all age groups with significant increasing trend, and these increases were highest in those aged <60 years (SRR = 2.34 [95% CI:2.11-2.58] in men and SRR = 2.76 [95% CI:2.54-3.00] in women). By contrast, there were significant decreases in the incidence of ADC in men and women of all ages (SRR = 0.60 [95% CI:0.54-0.67]) and (SRR = 0.63 [95% CI:0.56-0.71], respectively), with similar decreases in those aged <60 years and 60+ years. These competing trends still resulted in significant increases in the overall incidence of anal cancer in men and women of all ages groups with significant increasing trend. The SRRs in men of all ages, <60 years and 60+ years were 1.35 (95% CI:1.28-1.42), 1.77 (95% CI:1.62-1.92) and 1.08 (95% CI:1.00-1.15), respectively. The corresponding SRRs in women were 1.75 (95% CI:1.67-1.83), 2.31 (95% CI:2.14-2.48) and 1.38 (95% CI 1.31-1.46), respectively.

Conclusion: Increases in the incidence of anal SCC has driven an overall increase in anal cancer incidence; this may be associated with changing sexual behaviours and increasing levels of HPV exposure in younger cohorts. The findings further reinforce the importance of HPV vaccination.

PubMed Disclaimer

Conflict of interest statement

KC is co-Principal Investigator of an unrelated investigator-initiated trial of cytology and primary HPV screening for cervical cancer in Australia (Compass; ACTRN12613001207707 and NCT02328872), which is conducted and funded by the Victorian Cytology Service. The Victorian Cytology Service has received equipment and a funding contribution for the Compass trial from Roche Molecular Systems and Ventana. KC is also a Principal Investigator of Compass in New Zealand (Compass NZ; ACTRN12614000714684), which is conducted and funded by Diagnostic Medlab, now Auckland District Health Board. Diagnostic Medlab received equipment and a funding contribution for the Compass trial from Roche Molecular Systems. Neither KC nor her institution on her behalf (Cancer Council NSW) receive direct or indirect funding from industry for Compass Australia or NZ, or any other project. KC receives salary support from NHMRC Australia (Career Development Fellowship APP1082989). This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Pooled age-specific anal cancer incidence rates by birth cohort in men and women born from 1900 to 1983, for each of the five 5-yearly average rates (1988–92, 1993–97, 1998–2002, 2003–2007, 2008–2012).
SCC–squamous cell carcinoma; ADC–adenocarcinoma; M–male; F- female.
Fig 2
Fig 2. Pooled anal cancer incidence rates in selected high income countries, by region, sex, histological subtype and age group.
Note) Oceania includes Australia only. SCC–squamous cell carcinoma; ADC–adenocarcinoma; M–male; F- female.
See this image and copyright information in PMC

References

    1. Clark MA, Hartley A, Geh JI. Cancer of the anal canal. Lancet Oncol. 2004. March;5(3):149–57. 10.1016/S1470-2045(04)01410-X - DOI - PubMed
    1. de Martel C, Ferlay J, Franceschi S, Vignat J, Bray F, Forman D, et al. Global burden of cancers attributable to infections in 2008: a review and synthetic analysis. Lancet Oncol. 2012. June;13(6):607–15. 10.1016/S1470-2045(12)70137-7 - DOI - PubMed
    1. Alemany L, Saunier M, Alvarado-Cabrero I, Quiros B, Salmeron J, Shin HR, et al. Human papillomavirus DNA prevalence and type distribution in anal carcinomas worldwide. Int J Cancer. 2015. January 1;136(1):98–107. 10.1002/ijc.28963 - DOI - PMC - PubMed
    1. De Vuyst H, Clifford GM, Nascimento MC, Madeleine MM, Franceschi S. Prevalence and type distribution of human papillomavirus in carcinoma and intraepithelial neoplasia of the vulva, vagina and anus: a meta-analysis. Int J Cancer. 2009. 4/1/2009;124(7):1626–36. 10.1002/ijc.24116 - DOI - PubMed
    1. Bruni L, Barrionuevo-Rosas L, Albero G, Aldea M, Serrano B, Valencia S, et al. ICO Information Centre on HPV and Cancer (HPV Information Centre). Human Papillomavirus and Related Diseases in the World. Summary Report 2016-02-25.