Risk of Anal Cancer in a Cohort With Human Papillomavirus - Related Gynecologic Neoplasm.
Background: To assess the development of anal cancer in women diagnosed with a human
papillomavirus-related cervical, vulvar, or vaginal neoplasm. Methods: Using data from
National Cancer Institute's Surveillance, Epidemiology and End Results program from 1973
through 2007, 189,206 cases with either in situ or invasive cervical, vulvar, or vaginal
neoplasm were followed for 138,553,... read more519 person - years for the development of subsequent
primary anal cancer. Standardized incidence ratios were calculated from the observed
number of subsequent anal cancers compared with those expected based on age-, race- and
calendar year- specific rates in the nonaffected population. Results: Anal cancer
developed in 255 women with a history of in situ or invasive gynecologic neoplasm,
aggregate standardized incidence ratio of 13.6 (95% confidence interval [CI] 11.9 -
15.3), indicating a 13-fold increase in anal cancer compared with expected. The
standardized incidence ratio for anal cancer incidence among women with in situ vulvar
cancer was 22.2 (95% CI 16.7 - 28.4) and was 17.4 (95% CI 11.5 - 24.4) for those with
invasive vulvar cancer. The standardized incidence ratio for anal cancer incidence in
women with in situ cervical cancer was 16.4 (95% CI 13.7 - 19.2) and was 6.2 (95% CI 4.1
- 8.7) for women with invasive cervical cancer. The standardized incidence ratio for
anal cancer incidence among women with in situ vaginal cancer was 7.6 (95% CI 2.4 -
15.6) and was 1.8 (95% CI 0.2 - 5.3) for invasive vaginal cancer. Conclusions: Women
with human papillomavirus-related gynecologic neoplasm are at higher risk for developing
anal cancer compared with the general population. This high-risk population may benefit
from close observation and screening for anal
Thesis (M.S.)--Tufts University, 2011.
Submitted to the Dept. of Clinical & Translational Science.
Advisor: Jessica Paulus.
Keywords: Surgery, and Medicine.read less