Publication: Cervical determinants of anal HPV infection and high-grade anal lesions in women: a collaborative pooled analysis.
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Date
2019-06-13
Authors
Lin, Chunqing
Slama, Jiri
Gonzalez, Paula
Goodman, Marc T
Xia, Ningshao
Kreimer, Aimée R
Wu, Ting
Hessol, Nancy A
Shvetsov, Yurii
Ortiz, Ana P
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Abstract
Cervical cancer screening might contribute to the prevention of anal cancer in women. We aimed to investigate if routine cervical cancer screening results-namely high-risk human papillomavirus (HPV) infection and cytohistopathology-predict anal HPV16 infection, anal high-grade squamous intraepithelial lesions (HSIL) and, hence, anal cancer. We did a systematic review of MEDLINE, Embase, and the Cochrane library for studies of cervical determinants of anal HPV and HSIL published up to Aug 31, 2018. We centrally reanalysed individual-level data from 13 427 women with paired cervical and anal samples from 36 studies. We compared anal high-risk HPV prevalence by HIV status, cervical high-risk HPV, cervical cytohistopathology, age, and their combinations, using prevalence ratios (PR) and 95% CIs. Among 3255 women with anal cytohistopathology results, PRs were similarly calculated for all anal HSIL and HPV16-positive anal HSIL. Cervical and anal HPV infections were highly correlated. In HIV-negative women, anal HPV16 prevalence was 41% (447/1097) in cervical HPV16-positive versus 2% (214/8663) in cervical HPV16-negative women (PR 16·5, 95% CI 14·2-19·2, p HPV-based cervical cancer screening programmes might help to stratify anal cancer risk, irrespective of HIV status. For targeted secondary anal cancer prevention in high-risk groups, HIV-negative women with cervical HPV16, especially those older than 45 years, have a similar anal cancer risk profile to that of HIV-positive women. International Agency for Research on Cancer.
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MeSH Terms
Anus Neoplasms
Early Detection of Cancer
Female
Global Health
HIV Seropositivity
Human papillomavirus 16
Humans
Papillomavirus Infections
Prevalence
Uterine Cervical Neoplasms
Early Detection of Cancer
Female
Global Health
HIV Seropositivity
Human papillomavirus 16
Humans
Papillomavirus Infections
Prevalence
Uterine Cervical Neoplasms