Understanding the burden of human papillomavirus-associated anal cancers in the US

Authors

  • Djenaba A. Joseph MD, MPH,

    Corresponding author
    1. Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, Georgia
    • Centers for Disease Control and Prevention, Division of Cancer Prevention and Control, 4770 Buford Highway (K-55), Atlanta, GA 30341
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    • Fax: (770) 488-4639.

  • Jacqueline W. Miller MD,

    1. Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, Georgia
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  • Xiaocheng Wu MD, MPH,

    1. Louisiana Tumor Registry, Epidemiology Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, Louisiana
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  • Vivien W. Chen PhD,

    1. Louisiana Tumor Registry, Epidemiology Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, Louisiana
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  • Cyllene R. Morris DVM, PhD,

    1. Public Health Institute, California Cancer Registry, Sacramento, California
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  • Marc T. Goodman PhD, MPH,

    1. Cancer Research Center, University of Hawaii, Honolulu, Hawaii
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  • Jose M. Villalon-Gomez MD, MPH,

    1. Jamaica Hospital Medical Center, Mount Sinai School of Medicine Family Medicine Residency Program, New York, New York
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  • Melanie A. Williams PhD,

    1. Cancer Epidemiology and Surveillance Branch, Department of State Health Services, Austin, Texas
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  • Rosemary D. Cress DrPh

    1. Public Health Institute, California Cancer Registry, Sacramento, California
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  • This article is a US Government work and, as such, is in the public domain in the United States of America.

  • The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.

Abstract

BACKGROUND.

Anal cancer is an uncommon malignancy in the US; up to 93% of anal cancers are associated with human papillomavirus.

METHODS.

Cases diagnosed between 1998 and 2003 from 39 population-based cancer registries were analyzed. The following anal cancer histologies were included in the analysis: squamous cell, adenocarcinoma, and small cell/neuroendocrine carcinomas. Incidence rates were age-adjusted to the 2000 US standard population.

RESULTS.

From 1998 through 2003, the annual age-adjusted invasive anal cancer incidence rate was 1.5 per 100,000 persons. Squamous cell carcinoma (SCC) was the most common histology overall, accounting for 18,105 of 21,395 (84.6%) cases of anal cancer. Women had a higher rate of SCC (1.5 per 100,000) than men (1.0). Whites and blacks had the highest incidence rate (1.3), whereas Asians/Pacific Islanders (API) had the lowest rate (0.3). Incidence rates of anal SCC increased 2.6% per year on average. The majority of SCC cases were diagnosed at the in situ or localized stage (58.1%). API were more likely to be diagnosed with regional or distant stage disease than were other racial/ethnic groups (27.5% and 11.8%, respectively). Males had lower 5-year relative survival than females for all stages of disease.

CONCLUSIONS.

Rates of anal SCC varied by sex, race, and ethnicity. A higher proportion of API were diagnosed at regional/distant stage. Men had lower 5-year survival rates than women. Continued surveillance and additional research are needed to assess the potential impact of the HPV vaccine on the anal cancer burden in the US. Cancer 2008;113(10 suppl):2892–900. Published 2008 by the American Cancer Society.

Ancillary