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 - the SPANC study team
AU - Segelov, Eva
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. Abbreviations: AIN, anal intraepithelial neoplasia; ASIL, anal squamous intraepithelial lesion; CIN, cervical intraepithelial neoplasia; HSIL, high grade squamous intraepithelial lesion;HRA, high resolution anoscopy; HIV, human immunodeficiency virus; HPV, human papillomavirus; MSM, men who have sex with men; SPANC, Study for the Prevention of Anal 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. Abbreviations: AIN, anal intraepithelial neoplasia; ASIL, anal squamous intraepithelial lesion; CIN, cervical intraepithelial neoplasia; HSIL, high grade squamous intraepithelial lesion;HRA, high resolution anoscopy; HIV, human immunodeficiency virus; HPV, human papillomavirus; MSM, men who have sex with men; SPANC, Study for the Prevention of Anal Cancer.
KW - Cancer screening
KW - HSIL
KW - Human papillomavirus
KW - Risk factors
KW - Surrogate endpoints
UR - http://www.scopus.com/inward/record.url?scp=84973490562&partnerID=8YFLogxK
U2 - 10.1016/j.pvr.2016.05.003
DO - 10.1016/j.pvr.2016.05.003
M3 - Article
AN - SCOPUS:84973490562
SN - 2405-8521
VL - 2
SP - 97
EP - 105
JO - Papillomavirus Research
JF - Papillomavirus Research
ER -
