Trends in incidence and survival from anal cancer and incidence of high-grade anal intraepithelial neoplasia in Denmark |
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| Institution: | 1. Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, Copenhagen, Denmark;2. Statistics and Data Analysis, Danish Cancer Society Research Center, Strandboulevarden 49, Copenhagen, Denmark;3. Department of Gynecology, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, Copenhagen, Denmark;1. Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK;2. Clinical Effectiveness Unit, Royal College of Surgeons of England, London, UK;3. Department of Colorectal Surgery, Cambridge University Hospitals, Cambridge, UK;4. Department of Oncology, The Christie NHS Foundation Trust, School of Medical Sciences, University of Manchester Manchester, UK;5. Department of Oncology, Guy’s and St. Thomas’ NHS Foundation Trust, London, UK;1. Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China;2. Laboratory for Environmental Toxicology, Anhui Medical University, Hefei , Anhui 230032, China;1. Division of Pediatric Hematology Oncology, The Hospital for Sick Children, University of Toronto, Canada;2. Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada;3. Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada;4. Department of Psychiatry, University of Manitoba, Winnipeg, Canada;5. Department of Psychology, Memorial University, St. John’s, Newfoundland and Labrador, Canada;6. Department of Pediatric Hematology-Oncology, CancerCare Manitoba, Winnipeg, Canada;1. Infections and Cancer Epidemiology Division, German Cancer Research Center (DKFZ), Heidelberg, Germany;2. Department of Research, Cancer Registry of Norway, Oslo, Norway;3. Department of Epidemiology and Biostatistics, Imperial College London, London, UK;4. Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway;5. Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA;6. Cancer Registry of Norway, Oslo, Norway;7. Genetic Epidemiology Group (GEP), International Agency for Research on Cancer (IARC), Lyon, France;8. Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA;9. University of Bristol Dental School and University Hospitals Bristol and Weston NHS Foundation Trust Bristol, UK;1. School of Public Health, Fudan University, Shanghai 200032, China;2. State Key Laboratory of Oncogene and Related Genes & Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200032, China |
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| Abstract: | ObjectiveThe aim of the current study was to assess temporal trends in incidence of anal squamous cell carcinomas (SCC) and high-grade anal intraepithelial lesions (AIN2/3), and estimate survival from anal cancer and factors related to 5-year mortality in Denmark.MethodsWe analyzed anal SCC and AIN2/3 cases in the period of 1998–2018 from the Danish Cancer Register and the Danish Registry of Pathology, respectively. Overall, period, gender, and histology specific age-standardized incidence rates, average annual percentage change (AAPC), and 5-year relative survival were estimated. Cox proportional hazards models were applied to evaluate the effect on 5-year mortality of period, age, gender, and stage of disease.ResultsAltogether 2580 anal cancers and 871 AIN2/3 were identified. The AIN2/3 incidence increased for women 1998–2007 (AAPC: 3.5% (95% CI −0.7, 8.0)) and then tended to decrease during 2008–2018(AAPC: −5.2% (95% CI −9.6, −0.6)). A similar pattern was observed for men, although at a lower incidence with the decrease starting later (2008–2012) and the trend not reaching statistical significance. The anal SCC incidence increased over the whole study period for both women and men (women AAPC: 4.0% (95% CI 3.2%, 4.9%) and men AAPC: 3.6% (95% CI 2.3%, 4.9%)). The relative survival improved over time (from 61% to 72%). Being older and male was associated with a higher risk of dying within 5 years.ConclusionsThere is a need to focus attention on anal cancer and its precursor lesions, as the cancer incidence continues to increase. Actions could include screening and gender-neutral HPV vaccination. |
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| Keywords: | Anal cancer High-grade anal intraepithelial neoplasia Incidence Survival Human papillomavirus |
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