       Document 0770
 DOCN  M9460770
 TI    High incidence of anal cancer among AIDS patients. The AIDS/Cancer
       Working Group.
 DT    9404
 AU    Melbye M; Cote TR; Kessler L; Gail M; Biggar RJ; Danish Epidemiology
       Science Centre, State Serum Institute,; Copenhagen.
 SO    Lancet. 1994 Mar 12;343(8898):636-9. Unique Identifier : AIDSLINE
       MED/94158521
 AB    Until now, the only cancers that have been strongly associated with AIDS
       are Kaposi's sarcoma and non-Hodgkin lymphoma. We used a linkage between
       AIDS (50,050 reports) and cancer (859,398 reports) registries in seven
       health departments in the USA to investigate the association between HIV
       infection and epidermoid anal cancer. We compared the numbers of
       observed cases and expected cases, calculated from general population
       rates with adjustment for age, sex, and race. The relative risk of anal
       cancer at and after AIDS diagnosis was 84.1 (95% CI 46.4-152) among
       homosexual patients (11 cases) and 37.7 (9.4-151) among non-homosexual
       patients (2 cases). The relative risk of anal cancer up to 5 years
       before the AIDS diagnosis (23 cases) was also increased; it was 13.9
       (6.6-29.2) in the period 2-5 years before AIDS and 27.4 (15.9-47.2)
       during the 2 years before AIDS diagnosis (p for trend = 0.004). Among
       homosexual men, the relative risk of anal cancer was inversely related
       to age at AIDS onset (p for trend < 0.001). Excess risks were found in
       all geographical areas. This study establishes a strikingly increased
       risk of anal cancer among people with AIDS. These data are consistent
       with a previously hypothesized association between HIV-induced
       immunodeficiency and anal cancer development, but because homosexual men
       were at increased risk of anal cancer even before the AIDS epidemic, we
       cannot say how much of the increased risk is attributable to HIV
       infection. Nevertheless, clinicians should be aware that AIDS patients
       have an increased risk of anal cancer.
 DE    Acquired Immunodeficiency Syndrome/*COMPLICATIONS  Adult  Aged  Anus
       Neoplasms/EPIDEMIOLOGY/*ETIOLOGY  Carcinoma, Squamous
       Cell/EPIDEMIOLOGY/*ETIOLOGY  Female  Human  Incidence  Male  Middle Age
       Population Surveillance  Registries  Risk Factors  Support, Non-U.S.
       Gov't  Support, U.S. Gov't, P.H.S.  United States/EPIDEMIOLOGY  JOURNAL
       ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

