TY - JOUR
T1 - Prevalence and risk factors associated with high-grade anal squamous intraepithelial lesions (HSIL)-AIN2 and HSIL-AIN3 in homosexual men
AU - Machalek, Dorothy A.
AU - Jin, Fengyi
AU - Poynten, I. Mary
AU - Hillman, Richard J.
AU - Templeton, David J.
AU - Law, Carmella
AU - Roberts, Jennifer M.
AU - Tabrizi, Sepehr N.
AU - Garland, Suzanne M.
AU - Farnsworth, Annabelle
AU - Fairley, Christopher K.
AU - Grulich, Andrew E.
AU - Acraman, Brian
AU - Adams, Marjorie
AU - Carr, Andrew
AU - Carroll, Susan
AU - Cooper, David
AU - Cornall, Alyssa
AU - Crampton, Leonie
AU - Ekman, Deborah
AU - Feeney, Lance
AU - Fraissard, Eddie
AU - Howard, Kirsten
AU - Law, Matthew
AU - McCaffery, Kirsten
AU - McDonald, Ross
AU - McGrath, Patrick
AU - Mellor, Robert
AU - Norris, Richard
AU - O'Dwyer, Matthew
AU - Pendlebury, Susan
AU - Petoumenos, Kathy
AU - Phillips, Samuel
AU - Prestage, Garrett
AU - Richards, Adele
AU - Schema, Lance
AU - Seeds, Daniel
AU - Segelov, Eva
AU - Thurloe, Julia
AU - Tong, Winnie
AU - Varma, Rick
AU - SPANC Study Team
N1 - Copyright the Author(s) 2016. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.
PY - 2016/12/1
Y1 - 2016/12/1
N2 - Background: Anal intraepithelial neoplasia grade 2 (AIN2) and AIN grade 3 (AIN3) are commonly grouped together as high grade squamous intraepithelial lesions (HSIL). We assessed risk factors for HSIL-AIN2 and HSIL-AIN3 in a cohort of homosexual men. Methods: At the baseline visit in the Study for the Prevention of Anal Cancer (SPANC), all men completed a questionnaire and underwent anal swabbing for cytology and HPV genotyping, followed by high resolution anoscopy. Results: Composite-HSIL prevalence was 47% and 32% among 220 HIV-positive and 396 HIV-negative men, respectively. HSIL-AIN3 (37.7% versus 24.7%; p<0.001), but not HSIL-AIN2 (9.5% versus 7.6%; p=0.395) was more common in HIV-positive men. Recent receptive anal partners (p-trend=0.045), and increasing number of high-risk (HR)-HPV types (p-trend<0.001) were associated with HSIL-AIN2. Lifetime receptive partners (p-trend<0.001), HIV status (OR 1.74; 95% CI: 1.05-2.87) and HPV16 (OR 3.00; 95% CI: 1.56-5.75) were associated with HSIL-AIN3. HPV16 was the most common HR-HPV type detected in men with HSIL-AIN3, both HIV-negative (61.1%) and HIV-positive (54.9%). HPV16 was less commonly detected in men with HSIL-AIN2. Conclusions: Grouping HSIL-AIN2 and HSIL-AIN3 as HSIL may mask considerable heterogeneity in anal cancer risk. Given the strong link between HPV16 and anal cancer, men with HSIL-AIN3 and HPV16 are likely to be at greatest risk of cancer.
AB - Background: Anal intraepithelial neoplasia grade 2 (AIN2) and AIN grade 3 (AIN3) are commonly grouped together as high grade squamous intraepithelial lesions (HSIL). We assessed risk factors for HSIL-AIN2 and HSIL-AIN3 in a cohort of homosexual men. Methods: At the baseline visit in the Study for the Prevention of Anal Cancer (SPANC), all men completed a questionnaire and underwent anal swabbing for cytology and HPV genotyping, followed by high resolution anoscopy. Results: Composite-HSIL prevalence was 47% and 32% among 220 HIV-positive and 396 HIV-negative men, respectively. HSIL-AIN3 (37.7% versus 24.7%; p<0.001), but not HSIL-AIN2 (9.5% versus 7.6%; p=0.395) was more common in HIV-positive men. Recent receptive anal partners (p-trend=0.045), and increasing number of high-risk (HR)-HPV types (p-trend<0.001) were associated with HSIL-AIN2. Lifetime receptive partners (p-trend<0.001), HIV status (OR 1.74; 95% CI: 1.05-2.87) and HPV16 (OR 3.00; 95% CI: 1.56-5.75) were associated with HSIL-AIN3. HPV16 was the most common HR-HPV type detected in men with HSIL-AIN3, both HIV-negative (61.1%) and HIV-positive (54.9%). HPV16 was less commonly detected in men with HSIL-AIN2. Conclusions: Grouping HSIL-AIN2 and HSIL-AIN3 as HSIL may mask considerable heterogeneity in anal cancer risk. Given the strong link between HPV16 and anal cancer, men with HSIL-AIN3 and HPV16 are likely to be at greatest risk of cancer.
KW - risk factors
KW - surrogate endpoints
KW - HSIL
KW - cancer screening
KW - human papillomavirus
UR - http://www.scopus.com/inward/record.url?scp=84973490562&partnerID=8YFLogxK
UR - http://purl.org/au-research/grants/nhmrc/568971
U2 - 10.1016/j.pvr.2016.05.003
DO - 10.1016/j.pvr.2016.05.003
M3 - Article
C2 - 29074193
AN - SCOPUS:84973490562
VL - 2
SP - 97
EP - 105
JO - Papillomavirus Research
JF - Papillomavirus Research
SN - 2405-8521
ER -