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. 2021 Jan:7:133-143.
doi: 10.1200/GO.20.00299.

Squamous Cell Carcinoma of the Anus Incidence, Mortality, and Survival Among the General Population and Persons Living With HIV in Puerto Rico, 2000-2016

Karen J Ortiz-Ortiz  1   2   3 , Jeslie M Ramos-Cartagena  4 , Ashish A Deshmukh  5 , Carlos R Torres-Cintrón  3 , Vivian Colón-López  1   2 , Ana P Ortiz  1   6
Affiliations

Squamous Cell Carcinoma of the Anus Incidence, Mortality, and Survival Among the General Population and Persons Living With HIV in Puerto Rico, 2000-2016

Karen J Ortiz-Ortiz et al. JCO Glob Oncol. 2021 Jan.

Abstract

Purpose: Squamous cell carcinoma of the anus (SCCA) is common among persons living with HIV (PLWH). We described SCCA incidence and survival among the general population and among PLWH in Puerto Rico (PR), along with mortality of anal cancer.

Methods: PR HIV/AIDS Surveillance Program and the PR Central Cancer Registry databases were linked (2000-2016). Incidence rates (IRs) and trends (annual percent change [APC]) in SCCA and mortality rates and trends for anal cancer were estimated. Relative survival and relative excess risk (RER) of death were calculated.

Results: From 2000 to 2016, 991 individuals in PR were diagnosed with anal cancer; 73% of cases were SCCA 9.1% of SCCA and 1.5% of non-SCCA cases were in PLWH (P < .0001). SCCA incidence was higher among PLWH than the general population (IR = 27.7/100,000). Among PLWH, SCCA incidence (per 100,000) was the highest among men who have sex with men (IR = 60.5). From 2001-2016, SCCA incidence increased among the general population (APC: 4.90, P < .05); however, no significant change was observed among PLWH (APC = 0.19 and P = .96). The APC for anal cancer mortality in the general population was positive (3.9%) from 2000 to 2016, but not significant (P > .05). The 5-year relative survival of SCCA was 56.9% among PLWH and 66.8% among the general population. In multivariate analysis, the RER of death for SCCA 5 years postdiagnosis was affected by stage at diagnosis (distant: RER = 7.6, 95% CI, 2.36 to 24.25) but not by PLWH status (RER = 1.4, 95% CI, 0.67 to 3.01).

Conclusion: Our findings highlight the relevance of anal cancer screening in PLWH and HPV vaccination in both PLWH and the general population in PR, which could have an impact on the disease trend in the next few decades.

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Conflict of interest statement

Karen J. Ortiz-Ortiz

Research Funding: Abbvie

Ashish A. Deshmukh

Consulting or Advisory Role: Merck

Carlos R. Torres-Cintrón

Research Funding: Abbvie

Vivian Colón-López

Consulting or Advisory Role: Merck

Ana P. Ortiz

Consulting or Advisory Role: Merck

No other potential conflicts of interest were reported.

Figures

FIG 1
FIG 1
(A) Anal cancer in the overall general population and by sex, (B) SCCA in the overall general population and by sex, (C) SCCA among the overall general population and by age group.
FIG 2
FIG 2
SCCA among PLWH overall and by sex.
See this image and copyright information in PMC

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