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Anal cancer incidence is still rising in HIV-positive men and women.

BETHESDA, MD. -- Invasive squamous cell carcinoma of the anal canal continues to increase in HIV-positive men and women despite the widespread use of highly active antiretroviral therapy, Dr. E.Y. Chiao said at an international conference on malignancies in AIDS and other immunodeficiencies.

Fortunately, the percentage of cases diagnosed early also is increasing, as is 5-year survival, said Dr. Chiao of Memorial Sloan-Kettering Cancer Center, New York.

Data from the Surveillance, Epidemiology, and End Results program were analyzed to calculate trends in anal cancer incidence. Data were divided into three periods: the pre-HIV era (1973-1984), the HIV era (1985-1995), and the highly active antiretroviral therapy (HAART) era (1996-2000). Overall, there were 4,580 cases of invasive anal cancer. The incidence increased from 0.6 cases/100,000 people in the HIV era and 1/100,000 cases in the HAART era.

Initially, anal cancer incidence was much higher in men, but that gap narrowed over time. The ratio of male to female cases was 1.6:0.1 before the HIV era, and it dropped to 1.2:1 in the HAART era.

The incidence of anal cancer rose most strikingly in men and women aged 35-54 years. In men in that age group, the incidence rose from 0.6 in the HIV era to 1.3 in the HAART era. In women, it rose from 0.8 in the HIV era to 1.2 in the HAART era, Dr. Chiao said.

One encouraging trend was identified. Before the HIV era, 44% of cases were detected early. That rose to 51% in the HIV era and 60% in the HAART era. Also, 5-year relative survival increased from 53% in the pre-HIV era to 56% in the HIV era and 59% in the HAART era, Dr. Chiao said at the conference, sponsored by the National Cancer Institute.
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Title Annotation:Infectious Diseases
Publication:Internal Medicine News
Article Type:Brief Article
Geographic Code:1USA
Date:Jul 1, 2004
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