Risk of anal cancer in HIV-infected and HIV-uninfected individuals in North America

Michael J. Silverberg, Bryan Lau, Amy C. Justice, Eric Engels, M. John Gill, James J. Goedert, Gregory D. Kirk, Gypsyamber D'Souza, Ronald J. Bosch, John T. Brooks, Sonia Napravnik, Nancy A. Hessol, Lisa P. Jacobson, Mari M. Kitahata, Marina B. Klein, Richard D. Moore, Benigno Rodriguez, Sean B. Rourke, Michael S. Saag, Timothy R. SterlingKelly A. Gebo, Natasha Press, Jeffrey N. Martin, Robert Dubrow

Research output: Contribution to journalArticlepeer-review

360 Scopus citations


Background. Anal cancer is one of the most common cancers affecting individuals infected with human immunodeficiency virus (HIV), although few have evaluated rates separately for men who have sex with men (MSM), other men, and women. There are also conflicting data regarding calendar trends. Methods. In a study involving 13 cohorts from North America with follow-up between 1996 and 2007, we compared anal cancer incidence rates among 34189 HIV-infected (55% MSM, 19% other men, 26% women) and 114260 HIV-uninfected individuals (90% men).Results.Among men, the unadjusted anal cancer incidence rates per 100000 person-years were 131 for HIV-infected MSM, 46 for other HIV-infected men, and 2 for HIV-uninfected men, corresponding to demographically adjusted rate ratios (RRs) of 80.3 (95% confidence interval [CI], 42.7-151.1) for HIV-infected MSM and 26.7 (95% CI, 11.5-61.7) for other HIV-infected men compared with HIV-uninfected men. HIV-infected women had an anal cancer rate of 30/100000 person-years, and no cases were observed for HIV-uninfected women. In a multivariable Poisson regression model, among HIV-infected individuals, the risk was higher for MSM compared with other men (RR, 3.3; 95% CI, 1.8-6.0), but no difference was observed comparing women with other men (RR, 1.0; 95% CI, 0.5-2.2). In comparison with the period 2000-2003, HIV-infected individuals had an adjusted RR of 0.5 (95% CI,. 3-.9) in 1996-1999 and 0.9 (95% CI,. 6-1.2) in 2004-2007. Conclusions. Anal cancer rates were substantially higher for HIV-infected MSM, other men, and women compared with HIV-uninfected individuals, suggesting a need for universal prevention efforts. Rates increased after the early antiretroviral therapy era and then plateaued.

Original languageEnglish (US)
Pages (from-to)1026-1034
Number of pages9
JournalClinical Infectious Diseases
Issue number7
StatePublished - Apr 1 2012

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases


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