Front-to-back & dabbing wiping behaviour post-toilet associated with anal neoplasia & HR-HPV carriage in women with previous HPV-mediated gynaecological neoplasia |
| |
| Institution: | 1. Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia;2. Gynaecologic Oncology, Royal Hobart Hospital, Hobart, Australia;3. School of Medicine, University of Tasmania, Hobart, Australia;4. Regional HPV Labnet Reference Laboratory, Department of Microbiology and Infectious Diseases, The Royal Women?s Hospital, Parkville, Australia;5. Murdoch Childrens Research Institute, Parkville, Australia;6. Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Australia;1. Directorate for Health Information and Research, 95, G’mangia Hill, G’mangia, PTA 1313, Malta;2. Cancer Research UK Cancer Survival Group, Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK;1. KU Leuven – University of Leuven, Department of Oncology, Herestraat 49, B-3000 Leuven, Belgium;2. University Hospitals Leuven, Department of Radiation Oncology, Herestraat 49, B-3000 Leuven, Belgium;3. Belgian Cancer Registry, Koningsstraat 215 bus 7, B-1210 Brussels, Belgium;4. KU Leuven – University of Leuven, Department of Abdominal Surgery, Herestraat 49, B-3000 Leuven, Belgium;1. School of Health Sciences, University of Tampere, Tampere, Finland;2. Tampere University Hospital, Lahti Unit of Radiation Therapy, Lahti, Finland;3. Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway;4. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden;5. Icelandic Cancer Registry, Reykjavik, Iceland;6. Faculty of Medicine, University of Iceland, Reykjavik, Iceland;7. Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland;8. Department of Community Medicine, University of Tromsø, The Arctic University of Norway, Tromsø, Norway;9. Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland;1. Department of Advanced Operative and Oncologic Gynecology, Asklepios Hospital, Hamburg, Germany;2. Department of Obstetrics and Gynecology, Akdeniz University, Antalya, Turkey;3. Institute for Cytology and Dysplasia, Fürstenbergkarree, Berlin, Germany;4. Department of Radiooncology, University of Cologne, Cologne, Germany;5. Institute for Pathology, MVZ Hanse Histologicum, Hamburg, Germany;1. Department of Medicine, Baylor College of Medicine, Houston, TX, USA;2. Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael. E DeBakey VA Medical Center, Houston, TX, USA;3. Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA;4. Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA;5. Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA;6. Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom;7. Department of Cancer Biology, Department of GI Medical Oncology, University of Texas, M. D. Anderson Cancer Center, Houston, TX, USA;8. Texas Medical Center Digestive Disease Center, Houston, TX, USA;9. Dan L. Duncan Cancer Center at Baylor College of Medicine, Houston, TX, USA;10. Center for Translational Research on Inflammatory Diseases (CTRID), Michael E. DeBakey VA Medical Center, Houston, TX, USA;11. Michael E. DeBakey VA Medical Center, Houston, TX, USA |
| |
| Abstract: | BackgroundAnal cancer is a human papillomavirus (HPV)-mediated neoplasia of the anal squamous epithelium. Anal cancer is much more common among women, particularly those with a previous high-grade gynaecological neoplasia.MethodsCross-sectional study of women with a previous HPV-mediated gynaecological neoplasia in Tasmania, Australia. Women presenting for follow-up gynaecological care had anal swab samples taken for anal cytology by Hologic Liquid ThinPrep, followed by HPV genotyping. Women with abnormal anal cytology were invited for high-resolution anoscopy. Potential risk factors, including post-toilet wiping behaviours, were queried by questionnaire while clinical covariates were extracted from medical records. Covariates of anal outcomes evaluated by log-binomial and log-multinomial regression.ResultsFrom 163 women enrolled in the study, 65 (39.9%) had abnormal cytology, with 46 (28.2%) being high-grade. Of the 50 women with abnormal anal cytology having high-resolution anoscopy, 32 (64.0%) had abnormal histology with 13 (26.0%) being high-grade. Of the 123 women tested for HR-HPV DNA, 48 (39.0%) had HR-HPV detected, the most common genotypes being 16 and 51 (14/123, 11.4% for both).In addition to some known anal cancer risk factors, we found front-to-back wiping was associated with significantly increased (Prevalence ratio (PR) range: 1.99?3.60) prevalence of cytological and histological abnormality and HR-HPV carriage/co-carriage, while dabbing post-toilet was significantly associated with decreased prevalences (PR range: 0.50?0.62).ConclusionsPost-toilet wiping behaviours were significantly associated with the prevalence of anal cytological, histological and HR-HPV carriage outcomes. This suggests a biologically plausible mechanism for HR-HPV introduction and the higher frequencies of anal neoplasia in women. |
| |
| Keywords: | Anal neoplasia Epidemiology Women Human papillomavirus Post-toilet wiping Perineal hygiene |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
