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Cervical determinants of anal HPV infection and high-grade anal lesions in women: a collaborative pooled analysis


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Lin, C, Slama, J, Gonzalez, P, Goodman, MT, Xia, N, Kreimer, AR, Wu, T, Hessol, NA, Shvetsov, Y, Ortiz, AP, Grinsztejn, B, Moscicki, AB, Heard, I, Del Refugio Gonzalez Losa, M, Kojic, EM, Schim van der Loeff, MF, Wei, F, Longatto-Filho, A, Mbulawa, ZA, Palefsky, JM, Sohn, AH, Hernandez, BY, Robison, K, Simpson Jr, S ORCID: 0000-0001-6521-3056, Conley, LJ, de Pokomandy, A, van der Sande, MAB, Dube Mandishora, RS, Volpini, LPB, Pierangeli, A, Romero, B, Wilkin, T, Franceschi, S, Hidalgo-Tenorio, C, Ramautarsing, RA, Park, IU, Tso, FK, Godbole, S, D'Hauwers, KWM, Sehnal, B, Menezes, LJ, Heraclio, SA and Clifford, GM 2019 , 'Cervical determinants of anal HPV infection and high-grade anal lesions in women: a collaborative pooled analysis' , Lancet Infectious Diseases , pp. 1-12 , doi: 10.1016/S1473-3099(19)30164-1.

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Background: Cervical cancer screening might contribute to the prevention of anal cancer in women. We aimed to investigate if routine cervical cancer screening results-namely high-risk human papillomavirus (HPV) infection and cytohistopathology-predict anal HPV16 infection, anal high-grade squamous intraepithelial lesions (HSIL) and, hence, anal cancer.Methods: We did a systematic review of MEDLINE, Embase, and the Cochrane library for studies of cervical determinants of anal HPV and HSIL published up to Aug 31, 2018. We centrally reanalysed individual-level data from 13 427 women with paired cervical and anal samples from 36 studies. We compared anal high-risk HPV prevalence by HIV status, cervical high-risk HPV, cervical cytohistopathology, age, and their combinations, using prevalence ratios (PR) and 95% CIs. Among 3255 women with anal cytohistopathology results, PRs were similarly calculated for all anal HSIL and HPV16-positive anal HSIL.Findings: Cervical and anal HPV infections were highly correlated. In HIV-negative women, anal HPV16 prevalence was 41% (447/1097) in cervical HPV16-positive versus 2% (214/8663) in cervical HPV16-negative women (PR 16·5, 95% CI 14·2-19·2, pInterpretation: HPV-based cervical cancer screening programmes might help to stratify anal cancer risk, irrespective of HIV status. For targeted secondary anal cancer prevention in high-risk groups, HIV-negative women with cervical HPV16, especially those older than 45 years, have a similar anal cancer risk profile to that of HIV-positive women.

Item Type: Article
Authors/Creators:Lin, C and Slama, J and Gonzalez, P and Goodman, MT and Xia, N and Kreimer, AR and Wu, T and Hessol, NA and Shvetsov, Y and Ortiz, AP and Grinsztejn, B and Moscicki, AB and Heard, I and Del Refugio Gonzalez Losa, M and Kojic, EM and Schim van der Loeff, MF and Wei, F and Longatto-Filho, A and Mbulawa, ZA and Palefsky, JM and Sohn, AH and Hernandez, BY and Robison, K and Simpson Jr, S and Conley, LJ and de Pokomandy, A and van der Sande, MAB and Dube Mandishora, RS and Volpini, LPB and Pierangeli, A and Romero, B and Wilkin, T and Franceschi, S and Hidalgo-Tenorio, C and Ramautarsing, RA and Park, IU and Tso, FK and Godbole, S and D'Hauwers, KWM and Sehnal, B and Menezes, LJ and Heraclio, SA and Clifford, GM
Journal or Publication Title: Lancet Infectious Diseases
Publisher: Lancet Ltd
ISSN: 1473-3099
DOI / ID Number: 10.1016/S1473-3099(19)30164-1
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Copyright 2019 International Agency for Research on Cancer. Licensed under Creative Commons Attribution-NonCommercial-NoDerivs 3.0 IGO (CC BY-NC-ND 3.0 IGO)

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