Prevalence and associations of larger burden of intra-anal high-grade squamous intraepithelial lesions at baseline in an Australian cohort of gay and bisexual men: The Study of the Prevention of Anal Cancer

D J Templeton; C Williamson; F Jin; R J Hillman; J M Roberts; C Law; C K Fairley; S M Garland; A E Grulich; I M Poynten; Study of the Prevention of Anal Cancer (SPANC) Research Team

doi:10.1016/j.canep.2019.101661

Prevalence and associations of larger burden of intra-anal high-grade squamous intraepithelial lesions at baseline in an Australian cohort of gay and bisexual men: The Study of the Prevention of Anal Cancer

Cancer Epidemiol. 2020 Feb:64:101661. doi: 10.1016/j.canep.2019.101661. Epub 2020 Jan 7.

Authors

Affiliations

¹ The Kirby Institute, Wallace Wurth Building, UNSW Sydney, Randwick, New South Wales 2031, Australia; Department of Sexual Health Medicine, Sydney Local Heath District, 16 Marsden Street, Camperdown, Sydney, New South Wales 2050, Australia; Sydney Medical School, The University of Sydney, Sydney, New South Wales 2006, Australia. Electronic address: [email protected].
² Department of Sexual Health Medicine, Sydney Local Heath District, 16 Marsden Street, Camperdown, Sydney, New South Wales 2050, Australia; Sydney Medical School, The University of Sydney, Sydney, New South Wales 2006, Australia; The University of Aberdeen, School of Medicine and Dentristy, Polwarth Building, Foresterhill, Aberdeen AB25 2ZD, UK. Electronic address: [email protected].
³ The Kirby Institute, Wallace Wurth Building, UNSW Sydney, Randwick, New South Wales 2031, Australia. Electronic address: [email protected].
⁴ St Vincent's Hospital, 390 Victoria Street, Darlinghurst, Sydney, New South Wales 2010, Australia. Electronic address: [email protected].
⁵ Douglass Hanly Moir Pathology, 14 Giffnock Avenue, Macquarie Park, Sydney, New South Wales 2113, Australia. Electronic address: [email protected].
⁶ St Vincent's Hospital, 390 Victoria Street, Darlinghurst, Sydney, New South Wales 2010, Australia. Electronic address: [email protected].
⁷ Melbourne Sexual Health Centre, 580 Swanston Street, Carlton, Victoria 3053, Australia. Electronic address: [email protected].
⁸ Department of Microbiology and Infectious Diseases, Royal Women's Hospital, 20 Flemington Road, Parkville, Victoria 3052, Australia; Department of Microbiology, Royal Children's Hospital, 50 Flemington Road, Parkville, Victoria 3052, Australia; Infection Immunity, Murdoch Children's Research Institute, Flemington Road, Parkville, Victoria 3052, Australia; Department of Obstetrics and Gynaecology, University of Melbourne, Grattan Street, Parkville, New South Wales 3052, Australia. Electronic address: [email protected].
⁹ The Kirby Institute, Wallace Wurth Building, UNSW Sydney, Randwick, New South Wales 2031, Australia. Electronic address: [email protected].
¹⁰ The Kirby Institute, Wallace Wurth Building, UNSW Sydney, Randwick, New South Wales 2031, Australia. Electronic address: [email protected].

PMID: 31918181
DOI: 10.1016/j.canep.2019.101661

Abstract

Objectives: To investigate factors associated with larger burden of intra-anal high-grade squamous intraepithelial lesions (HSIL) in a natural history study of HSIL.

Methods: 617 gay and bisexual men (GBM) attended a baseline visit. High-resolution anoscopy-directed biopsy was performed of suspected HSIL. GBM with biopsy-confirmed HSIL (bHSIL) affecting a single-octant were compared with those who had bHSIL affecting a larger area.

Results: Of 196 men with bHSIL at baseline, 73 (37.2 %) had larger bHSIL burden. Larger burden was independently associated with anal HPV16 detection (aOR 2.06, 95 % CI 1.09-3.89, p = 0.026) and infection with a greater number of high-risk HPV types (aOR per type increase 1.25, 95 % CI 1.05-1.49, p-trend = 0.010).

Conclusion: The observation that men with a larger burden of HSIL also had more risk factors for anal cancer suggests this group may warrant closer observation to ensure earlier detection, and thus improved prognosis, of individuals whose HSIL may progress to anal cancer.

Keywords: Anal canal; HPV; Homosexuality; Male; Precancerous conditions; Tumor burden.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Anus Neoplasms / epidemiology*
Anus Neoplasms / pathology
Anus Neoplasms / prevention & control
Anus Neoplasms / virology
Australia / epidemiology
Cohort Studies
Female
Homosexuality, Male / statistics & numerical data*
Human papillomavirus 16 / isolation & purification
Humans
Male
Middle Aged
Neoplasm Grading
Papillomavirus Infections / epidemiology
Papillomavirus Infections / pathology
Papillomavirus Infections / virology
Prevalence
Prospective Studies
Risk Factors
Sexual and Gender Minorities / statistics & numerical data*
Squamous Intraepithelial Lesions / epidemiology*
Squamous Intraepithelial Lesions / pathology
Squamous Intraepithelial Lesions / virology
Tumor Burden