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Eric A Engels - One of the best experts on this subject based on the ideXlab platform.

  • A meta-Analysis of Anal Cancer incidence by risk group: Toward a unified Anal Cancer risk scale.
    International journal of cancer, 2020
    Co-Authors: Gary M. Clifford, Eric A Engels, Meredith S. Shiels, Damien Georges, Andreia Albuquerque, Isobel Mary Poynten, Alexandra De Pokomandy, Alexandra M. Easson, Elizabeth A. Stier
    Abstract:

    Certain population groups are known to have higher than average Anal Cancer risk, namely persons living with HIV (PLHIV), men who have sex with men (MSM), women diagnosed with human papillomavirus (HPV)-related gynecological preCancerous lesions or Cancer, solid organ transplant recipients (SOTRs) and patients with autoimmune diseases. Our aim was to provide robust and comparable estimates of Anal Cancer burden across these groups. Summary incidence rates (IRs), as cases per 100 000 person-years (py), were calculated by fixed-effects meta-Analysis. IRs were 85 (95% confidence interval [CI] = 82-89) for HIV-positive MSM (n = 7 studies; 2 229 234 py), 32 (95% CI = 30-35) for non-MSM male PLHIV (n = 5; 1626 448 py) and 22 (95% CI = 19-24) for female PLHIV (n = 6; 1 472 123 py), with strong variation by age (eg, from 16.8 10 years after transplant. Anal Cancer IRs were 10 (95% CI = 5-19), 6 (95% CI = 3-11) and 3 (95% CI = 2-4) for systemic lupus erythematosus, ulcerative colitis and Crohn's disease, respectively. In conclusion, a unifying Anal Cancer risk scale, based upon comprehensive meta-Analysis, can improve prioritization and standardization in Anal Cancer prevention/research initiatives, which are in their public health infancy.

  • Anal Cancer Risk Among People With HIV Infection in the United States.
    Journal of Clinical Oncology, 2017
    Co-Authors: Vivian Colón-lópez, Mark Machin, Ana P. Ortiz, Philip E Castle, Howard D Strickler, Ruth M Pfeiffer, Meredith S. Shiels, Eric A Engels
    Abstract:

    PurposePeople with HIV infection have an elevated risk of Anal Cancer. However, recent calendar trends are incompletely described, and which population subgroups might benefit from Cancer screening is unknown.MethodsWe used linked data from HIV and Cancer registries in nine US areas (1996 to 2012). We calculated standardized incidence ratios to compare Anal Cancer incidence in people with HIV infection with the general population, used Poisson regression to evaluate Anal Cancer incidence among subgroups of people with HIV and to assess temporal trends, and estimated the cumulative incidence of Anal Cancer to measure absolute risk.ResultsAmong 447,953 people with HIV infection, Anal Cancer incidence was much higher than in the general population (standardized incidence ratio, 19.1; 95% CI, 18.1 to 20.0). Anal Cancer incidence was highest among men who have sex with men (MSM), increased with age, and was higher in people with AIDS than in those without AIDS (ie, HIV only; adjusted incidence rate ratio, 3.82...

  • Impact of the HIV Epidemic on the Incidence Rates of Anal Cancer in the United States
    Journal of the National Cancer Institute, 2012
    Co-Authors: Meredith S. Shiels, Ruth M Pfeiffer, Aimée R. Kreimer, Anil K. Chaturvedi, Eric A Engels
    Abstract:

    Methods Data on Anal Cancer cases with and without AIDS were obtained from the HIV/AIDS Cancer Match Study. The number of HIV-infected Anal Cancer cases without AIDS was estimated from the number of Anal Cancers occurring before diagnosis of AIDS. The proportion of Anal Cancer cases with HIV infection in the general population was calculated. We estimated temporal trends in the incidence rates of Anal Cancer in the general population overall and after exclusion of HIV-infected Cancer cases by calculating annual percent changes and 95% confidence intervals (CIs) using a Joinpoint log-linear model. All incidence rates were standardized to the 2000 US population by age, sex, and race. Results During 1980–2005, of the 20 533 estimated Anal Cancer cases, 1665 (8.1%) were HIV-infected. During 2001–2005, the proportion of Anal Cancer cases with HIV infection was the highest—1.2% (95% CI = 0.93 to 1.4%) among females and 28.4% (95% CI = 26.6 to 29.4%) among males. During 1980–2005, HIV infection did not have an impact on the trends in Anal Cancer among females (incidence rates increased by 3.3% [95% CI = 3.0 to 3.7%] annually overall, and by 3.3% [95% CI = 2.9 to 3.6%] annually without HIV-infected Anal Cancer cases) but had a strong impact on the trends in Anal Cancer among males (incidence rates increased by 3.4% [95% CI = 2.9 to 3.9%] annually overall, and by 1.7% [95% CI = 1.2 to 2.3%] annually without HIV infection).

  • The impact of the HIV epidemic on U.S. Anal Cancer rates, 1980-2007
    Infectious Agents and Cancer, 2012
    Co-Authors: Meredith S. Shiels, Ruth M Pfeiffer, Aimée R. Kreimer, Anil K. Chaturvedi, Eric A Engels
    Abstract:

    Background U.S. incidence rates of Anal Cancer have increased steadily over time, and are generally higher in women than men. It has been proposed that the HIV epidemic may have influenced U.S. Anal Cancer trends. Compared to the general population, Anal Cancer rates are strongly elevated in HIV-infected individuals. Anal Cancer rates in HIV-infected individuals have also increased over time. We estimated the impact of the HIV epidemic on U.S. Anal Cancer trends during 1980-2007.

Joel M. Palefsky - One of the best experts on this subject based on the ideXlab platform.

  • Risk of Anal Cancer Following Benign Anal Disease and Anal Cancer Precursor Lesions: A Danish Nationwide Cohort Study.
    Cancer epidemiology biomarkers & prevention : a publication of the American Association for Cancer Research cosponsored by the American Society of Pre, 2019
    Co-Authors: Mette Tuxen Faber, Kirsten Frederiksen, Joel M. Palefsky, Susanne K. Kjaer
    Abstract:

    Background: Human papillomavirus (HPV) is associated with the majority of Anal high-grade intraepithelial neoplasia (AIN) and Anal Cancers. Little is known about the risk of Anal Cancer following a diagnosis of benign Anal disease and AIN. Methods: Using data from nationwide, population-based Danish registries, a cohort of 126,174 individuals with either non-neoplastic Anal disease or AIN 1 to 3 during 1970 to 2016 was followed until first occasion of Anal Cancer. Information on HIV status was obtained from the Danish HIV Cohort Study. The absolute risk of Anal Cancer was estimated using the Aalen-Johansen estimator taking into account censoring at emigration and end of follow-up and competing risk at time of death. Standardized incidence ratios (SIR) for Anal Cancer among individuals with non-neoplastic Anal disease, including inflammatory lesions, hemorrhoids, and polyps, were estimated in Poisson models. Sex-, age-, and calendar period-specific national population rates were estimated using the Danish National Pathology Registry. Results: Anal Cancer risk increased with increasing severity of lesions, reaching 4% 5 years after diagnosis of AIN3. Even among those with non-neoplastic Anal lesions, particularly inflammatory lesions, Anal Cancer risk was significantly higher than expected from Danish national Anal Cancer rates (SIR = 2.8; 95% confidence intervals, 2.3–3.2). The absolute 5-year risk of Anal Cancer following AIN3 was considerably higher among HIV-positive (14.1%) than HIV-negative (3.2%) individuals. Conclusions: Anal Cancer risk increases with increasing severity of lesions and is especially high among HIV-positive individuals. Impact: Vaccination against HPV is important in the prevention of both high-grade AIN and Anal Cancer.

  • HPV-Associated Anal Cancer in the HIV/AIDS Patient.
    Cancer treatment and research, 2018
    Co-Authors: Chia Ching J. Wang, Joel M. Palefsky
    Abstract:

    The prevalence of Anal human papillomavirus (HPV) infection and Anal high-grade squamous intraepithelial lesion (HSIL) remain high among HIV-infected individuals on effective antiretroviral therapy (ART). The incidence of HPV-related Anal Cancers has continued to increase since the introduction of ART. Therefore, ART may confer only limited benefit with respect to reducing the risk of Anal HSIL and Cancer. Efforts are in progress to define the efficacy of secondary prevention programs for prevention of Anal Cancer. In the modern ART era, Anal Cancer recurrence and survival outcomes are similar in HIV-infected and HIV-uninfected patients, but HIV-infected patients may experience more toxicities. This article reviews the current literature on HPV-associated Anal Cancer in the HIV-infected population, including epidemiology, screening, clinical characteristics, and treatment outcomes.

  • Human Immunodeficiency Virus/AIDS, Human Papillomavirus, and Anal Cancer.
    Surgical oncology clinics of North America, 2017
    Co-Authors: Chia Ching J. Wang, Joseph A. Sparano, Joel M. Palefsky
    Abstract:

    Anal Cancer is an increasingly common non-AIDS-defining Cancer among individuals infected with the human immunodeficiency virus (HIV). It is associated with human papillomavirus (HPV). HPV16 is the most common genotype detected in Anal Cancers. The HPV types detected in Anal Cancer are included in the 9-valent vaccine. HPV vaccines have demonstrated efficacy in reducing Anal preCancerous lesions in HIV-infected individuals. Standard treatment has been fluorouracil and mitomycin (or cisplatin) plus radiation. Continued studies are needed to test new treatment strategies in HIV-infected patients with Anal Cancer to determine which treatment protocols provide the best therapeutic index.

  • Human papillomavirus type distribution in Anal Cancer and Anal intraepithelial lesions
    International journal of cancer, 2009
    Co-Authors: Brooke E. Hoots, Joel M. Palefsky, Jeanne M. Pimenta, Jennifer S. Smith
    Abstract:

    A systematic review was conducted of HPV type distribution in Anal Cancer and Anal high-grade and low-grade squamous intraepithelial lesions (HSIL and LSIL). A Medline search of studies using PCR or hybrid capture for HPV DNA detection was completed. A total of 1,824 cases were included: 992 invasive Anal Cancers, 472 HSIL cases and 360 LSIL cases. Crude HPV prevalence in Anal Cancer, HSIL, and LSIL was 71, 91 and 88%, respectively. HPV16/18 prevalence was 72% in invasive Anal Cancer, 69% in HSIL and 27% in LSIL. The HPV 16 and/or 18 prevalence in invasive Anal Cancer cases was similar to that reported in invasive cervical Cancer. If ongoing clinical trials show efficacy in preventing Anal HPV infection and associated Anal lesions, prophylactic HPV vaccines may play an important role for the primary prevention of these Cancers in both genders.

  • Anal Cancer prevention in HIV-positive men and women
    Current opinion in oncology, 2009
    Co-Authors: Joel M. Palefsky
    Abstract:

    Purpose of review The incidence of human papillomavirus (HPV)-associated Anal Cancer is unacceptably high among HIV-positive men who have sex with men (MSM) and possibly in HIV-positive women. Unlike most other malignancies occurring in the HIV-positive population, Anal Cancer is potentially preventable, using methods similar to those used to prevent cervical Cancer in women. This review discusses the issues around screening to prevent Anal Cancer.

Meredith S. Shiels - One of the best experts on this subject based on the ideXlab platform.

  • A meta-Analysis of Anal Cancer incidence by risk group: Toward a unified Anal Cancer risk scale.
    International journal of cancer, 2020
    Co-Authors: Gary M. Clifford, Eric A Engels, Meredith S. Shiels, Damien Georges, Andreia Albuquerque, Isobel Mary Poynten, Alexandra De Pokomandy, Alexandra M. Easson, Elizabeth A. Stier
    Abstract:

    Certain population groups are known to have higher than average Anal Cancer risk, namely persons living with HIV (PLHIV), men who have sex with men (MSM), women diagnosed with human papillomavirus (HPV)-related gynecological preCancerous lesions or Cancer, solid organ transplant recipients (SOTRs) and patients with autoimmune diseases. Our aim was to provide robust and comparable estimates of Anal Cancer burden across these groups. Summary incidence rates (IRs), as cases per 100 000 person-years (py), were calculated by fixed-effects meta-Analysis. IRs were 85 (95% confidence interval [CI] = 82-89) for HIV-positive MSM (n = 7 studies; 2 229 234 py), 32 (95% CI = 30-35) for non-MSM male PLHIV (n = 5; 1626 448 py) and 22 (95% CI = 19-24) for female PLHIV (n = 6; 1 472 123 py), with strong variation by age (eg, from 16.8 10 years after transplant. Anal Cancer IRs were 10 (95% CI = 5-19), 6 (95% CI = 3-11) and 3 (95% CI = 2-4) for systemic lupus erythematosus, ulcerative colitis and Crohn's disease, respectively. In conclusion, a unifying Anal Cancer risk scale, based upon comprehensive meta-Analysis, can improve prioritization and standardization in Anal Cancer prevention/research initiatives, which are in their public health infancy.

  • Anal Cancer Risk Among People With HIV Infection in the United States.
    Journal of Clinical Oncology, 2017
    Co-Authors: Vivian Colón-lópez, Mark Machin, Ana P. Ortiz, Philip E Castle, Howard D Strickler, Ruth M Pfeiffer, Meredith S. Shiels, Eric A Engels
    Abstract:

    PurposePeople with HIV infection have an elevated risk of Anal Cancer. However, recent calendar trends are incompletely described, and which population subgroups might benefit from Cancer screening is unknown.MethodsWe used linked data from HIV and Cancer registries in nine US areas (1996 to 2012). We calculated standardized incidence ratios to compare Anal Cancer incidence in people with HIV infection with the general population, used Poisson regression to evaluate Anal Cancer incidence among subgroups of people with HIV and to assess temporal trends, and estimated the cumulative incidence of Anal Cancer to measure absolute risk.ResultsAmong 447,953 people with HIV infection, Anal Cancer incidence was much higher than in the general population (standardized incidence ratio, 19.1; 95% CI, 18.1 to 20.0). Anal Cancer incidence was highest among men who have sex with men (MSM), increased with age, and was higher in people with AIDS than in those without AIDS (ie, HIV only; adjusted incidence rate ratio, 3.82...

  • Impact of the HIV Epidemic on the Incidence Rates of Anal Cancer in the United States
    Journal of the National Cancer Institute, 2012
    Co-Authors: Meredith S. Shiels, Ruth M Pfeiffer, Aimée R. Kreimer, Anil K. Chaturvedi, Eric A Engels
    Abstract:

    Methods Data on Anal Cancer cases with and without AIDS were obtained from the HIV/AIDS Cancer Match Study. The number of HIV-infected Anal Cancer cases without AIDS was estimated from the number of Anal Cancers occurring before diagnosis of AIDS. The proportion of Anal Cancer cases with HIV infection in the general population was calculated. We estimated temporal trends in the incidence rates of Anal Cancer in the general population overall and after exclusion of HIV-infected Cancer cases by calculating annual percent changes and 95% confidence intervals (CIs) using a Joinpoint log-linear model. All incidence rates were standardized to the 2000 US population by age, sex, and race. Results During 1980–2005, of the 20 533 estimated Anal Cancer cases, 1665 (8.1%) were HIV-infected. During 2001–2005, the proportion of Anal Cancer cases with HIV infection was the highest—1.2% (95% CI = 0.93 to 1.4%) among females and 28.4% (95% CI = 26.6 to 29.4%) among males. During 1980–2005, HIV infection did not have an impact on the trends in Anal Cancer among females (incidence rates increased by 3.3% [95% CI = 3.0 to 3.7%] annually overall, and by 3.3% [95% CI = 2.9 to 3.6%] annually without HIV-infected Anal Cancer cases) but had a strong impact on the trends in Anal Cancer among males (incidence rates increased by 3.4% [95% CI = 2.9 to 3.9%] annually overall, and by 1.7% [95% CI = 1.2 to 2.3%] annually without HIV infection).

  • The impact of the HIV epidemic on U.S. Anal Cancer rates, 1980-2007
    Infectious Agents and Cancer, 2012
    Co-Authors: Meredith S. Shiels, Ruth M Pfeiffer, Aimée R. Kreimer, Anil K. Chaturvedi, Eric A Engels
    Abstract:

    Background U.S. incidence rates of Anal Cancer have increased steadily over time, and are generally higher in women than men. It has been proposed that the HIV epidemic may have influenced U.S. Anal Cancer trends. Compared to the general population, Anal Cancer rates are strongly elevated in HIV-infected individuals. Anal Cancer rates in HIV-infected individuals have also increased over time. We estimated the impact of the HIV epidemic on U.S. Anal Cancer trends during 1980-2007.

Mark Bower - One of the best experts on this subject based on the ideXlab platform.

  • The features and outcome of HIV-associated Anal Cancer in screened and unscreened populations.
    Journal of Clinical Oncology, 2012
    Co-Authors: Thomas Newsom-davis, Paul Fox, Victoria Bradley, Alessia Dalla Pria, Mark Nelson, Mark Bower
    Abstract:

    e14574 Background: The aims of screening for Anal Cancer are to prevent invasive Anal Cancer and/or to detect it at an early and hence more curable stage. We sought to evaluate differences in clinicopathological features and outcomes of HIV associated Anal Cancer between patients who were enrolled on a programme of high resolution anoscopy (HRA) surveillance and those who were not. Methods: A retrospective study of patients diagnosed with Anal Cancer was undertaken based on our HIV Cancer registry. Results: Since 1989, 74 patients (73 male) have been diagnosed and treated for HIV-associated invasive Anal Cancer, including 7 patients who had been enrolled onto an HRA screening programme. The surveillance patients had undergone a total of 26 examinations starting a median of 3.8 years (range: 0.3-8.7) prior to Cancer diagnosis. At Anal Cancer diagnosis, the screened patients were older (median age: 50 years, range: 45-61 vs 44, range: 28-75, p=0.04), had higher CD4 cell counts (median CD4: 575 /mm3, range: ...

  • chemoradiotherapy for Anal Cancer in hiv patients causes prolonged cd4 cell count suppression
    Annals of Oncology, 2012
    Co-Authors: Maryam Alfawali, T Allenmersh, Anthony Antoniou, D Tait, T Newsomdavis, B Gazzard, M Nelson, Mark Bower
    Abstract:

    Background: Despite the advent of highly active antiretroviral therapy, Anal Cancer remains a significant health problem in human immunodeficiency virus (HIV) patients. We present the clinical features and treatment outcomes of Anal Cancer in 60 HIV-positive patients over a 20-year period. Patients and methods: A prospective database of all HIV-positive individuals managed in a specialist unit since 1986 includes 11 112 patients (71 687 person-years of follow-up). Sixty patients with Anal Cancer were identified. Their clinicopathological and treatment details were Analysed. Results: At Anal Cancer diagnosis, the mean age was 44 years (range: 28-75 years) and the median CD4 cell count was 305 mm(-3) (range: 16-1252 mm(-3)). Fifty (83%) had chemoradiotherapy (CRT). Forty-six (92%) responded, of whom 10 (22%) subsequently relapsed with locoregional (70%), metastatic disease (10%) or both (20%). The overall 5-year survival is 65% (95% confidence interval 51% to 78%). The median CD4 count fell from 289 mm(-3) before CRT to 132 mm(-3) after 3 months and to 189 mm(-3) after 1 year (P < 0.05). Six patients in remission of Anal Cancer died of acquired immunodeficiency syndrome defining illnesses. Conclusions: The management of Anal Cancer with CRT achieves similar outcomes as the general population. CRT is associated with significant prolonged CD4 suppression that may contribute to late deaths of patients in remission.

  • HIV-associated Anal Cancer
    F1000 medicine reports, 2010
    Co-Authors: Thomas Newsom-davis, Mark Bower
    Abstract:

    HIV-associated Anal carcinoma, a non-AIDS-defining Cancer, is a human papillomavirus-associated malignancy with a spectrum of preinvasive changes. The standardized incidence ratio for Anal Cancer in patients with HIV/AIDS is 20-50. Algorithms for Anal Cancer screening include Anal cytology followed by high-resolution anoscopy for those with abnormal findings. Outpatient topical treatments for Anal intraepithelial neoplasia include infrared coagulation therapy, trichloroacetic acid, and imiquimod. The development of cost-effective national screening programs for HIV-associated Anal Cancer remains a challenge.

Ruth M Pfeiffer - One of the best experts on this subject based on the ideXlab platform.

  • Anal Cancer Risk Among People With HIV Infection in the United States.
    Journal of Clinical Oncology, 2017
    Co-Authors: Vivian Colón-lópez, Mark Machin, Ana P. Ortiz, Philip E Castle, Howard D Strickler, Ruth M Pfeiffer, Meredith S. Shiels, Eric A Engels
    Abstract:

    PurposePeople with HIV infection have an elevated risk of Anal Cancer. However, recent calendar trends are incompletely described, and which population subgroups might benefit from Cancer screening is unknown.MethodsWe used linked data from HIV and Cancer registries in nine US areas (1996 to 2012). We calculated standardized incidence ratios to compare Anal Cancer incidence in people with HIV infection with the general population, used Poisson regression to evaluate Anal Cancer incidence among subgroups of people with HIV and to assess temporal trends, and estimated the cumulative incidence of Anal Cancer to measure absolute risk.ResultsAmong 447,953 people with HIV infection, Anal Cancer incidence was much higher than in the general population (standardized incidence ratio, 19.1; 95% CI, 18.1 to 20.0). Anal Cancer incidence was highest among men who have sex with men (MSM), increased with age, and was higher in people with AIDS than in those without AIDS (ie, HIV only; adjusted incidence rate ratio, 3.82...

  • Impact of the HIV Epidemic on the Incidence Rates of Anal Cancer in the United States
    Journal of the National Cancer Institute, 2012
    Co-Authors: Meredith S. Shiels, Ruth M Pfeiffer, Aimée R. Kreimer, Anil K. Chaturvedi, Eric A Engels
    Abstract:

    Methods Data on Anal Cancer cases with and without AIDS were obtained from the HIV/AIDS Cancer Match Study. The number of HIV-infected Anal Cancer cases without AIDS was estimated from the number of Anal Cancers occurring before diagnosis of AIDS. The proportion of Anal Cancer cases with HIV infection in the general population was calculated. We estimated temporal trends in the incidence rates of Anal Cancer in the general population overall and after exclusion of HIV-infected Cancer cases by calculating annual percent changes and 95% confidence intervals (CIs) using a Joinpoint log-linear model. All incidence rates were standardized to the 2000 US population by age, sex, and race. Results During 1980–2005, of the 20 533 estimated Anal Cancer cases, 1665 (8.1%) were HIV-infected. During 2001–2005, the proportion of Anal Cancer cases with HIV infection was the highest—1.2% (95% CI = 0.93 to 1.4%) among females and 28.4% (95% CI = 26.6 to 29.4%) among males. During 1980–2005, HIV infection did not have an impact on the trends in Anal Cancer among females (incidence rates increased by 3.3% [95% CI = 3.0 to 3.7%] annually overall, and by 3.3% [95% CI = 2.9 to 3.6%] annually without HIV-infected Anal Cancer cases) but had a strong impact on the trends in Anal Cancer among males (incidence rates increased by 3.4% [95% CI = 2.9 to 3.9%] annually overall, and by 1.7% [95% CI = 1.2 to 2.3%] annually without HIV infection).

  • The impact of the HIV epidemic on U.S. Anal Cancer rates, 1980-2007
    Infectious Agents and Cancer, 2012
    Co-Authors: Meredith S. Shiels, Ruth M Pfeiffer, Aimée R. Kreimer, Anil K. Chaturvedi, Eric A Engels
    Abstract:

    Background U.S. incidence rates of Anal Cancer have increased steadily over time, and are generally higher in women than men. It has been proposed that the HIV epidemic may have influenced U.S. Anal Cancer trends. Compared to the general population, Anal Cancer rates are strongly elevated in HIV-infected individuals. Anal Cancer rates in HIV-infected individuals have also increased over time. We estimated the impact of the HIV epidemic on U.S. Anal Cancer trends during 1980-2007.