Impact of HIV on Anal Squamous Cell Carcinoma Rates in the United States, 2001-2015
Menée à l'aide de données de registres des cancers et du VIH dans 12 régions des États-Unis, cette étude analyse l'évolution, sur la période 2001-2015, de l'incidence du carcinome épidermoïde anal chez les personnes infectées par le VIH
Incidence of anal squamous cell carcinoma (SCC) has increased in the U.S. Persons living with HIV (PLWH) have an elevated risk of anal SCC, and changes in the number of anal SCCs among PLWH may have influenced general population trends.Data were obtained from a linkage of HIV and cancer registries in 12 U.S. regions. The proportion of anal SCCs occurring among PLWH was estimated by sex, age group and race and ethnicity. To assess the impact of anal SCCs among PLWH on general population trends, annual percentage changes (APCs) in incidence rates including and excluding anal SCCs among PLWH were estimated.Between 2001-2015, 14.5% of 16,110 anal SCC diagnoses occurred in PLWH. In 2013-2015, 33% of anal SCCs among men occurred in PLWH, but only 3% among women. The proportion of anal SCCs among PLWH was highest among 20-49-year-olds and Black and Hispanic individuals. General population anal SCC trends among men were strongly influenced by cases among PLWH: rates increased 4.6%/year [95% confidence interval (CI): 1.4%, 8.0%] from 2001-2009 followed by a non-significant decline (APC: -2.7%/year [95%CI: -7.1, 2.0%]) from 2009-2015, but without anal SCCs among PLWH, rates were stable (APC: 0.7%, [95%CI: -0.8%-2.3%]). Anal SCC rates among women increased 3.8%/year (95%CI 3.2%-4.4%) during 2001-2012 and then declined non-significantly (APC=-3.8; 95%CI -6.9, -0.6), and anal SCCs among PLWH had little impact on these trends.During 2001-2015, anal SCCs among PLWH contributed strongly to changes in incidence trends in the general U.S. population among men, but not women.