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1994-06-12
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Document 0184
DOCN M9460184
TI Changing patterns of anal cancer incidence in the United States,
1940-1989.
DT 9408
AU Melbye M; Rabkin C; Frisch M; Biggar RJ; Danish Epidemiology Science
Centre, State Serum Institute,; Copenhagen.
SO Am J Epidemiol. 1994 Apr 15;139(8):772-80. Unique Identifier : AIDSLINE
MED/94234106
AB Anal cancer has been hypothesized to be associated with a sexually
transmitted agent and, more recently, with the epidemic of human
immunodeficiency virus (HIV). The authors used a descriptive incidence
study to evaluate these hypotheses based on US data from the
Surveillance, Epidemiology, and End Results (SEER) program for 1973-1989
and from the Connecticut Tumor Registry for 1940-1988. Since 1960, anal
cancer incidence in Connecticut increased 1.9-fold among men and
2.3-fold among women. Based on information from SEER, the incidence was
lowest among white men (1973-1989 average: 0.41/100,000) and highest
among black women (1973-1989 average: 0.74/100,000). Residents of the
metropolitan areas had a twofold risk of anal cancer compared with
populations in less densely populated areas. The most dramatic change in
incidence was observed for white men in the San Francisco Bay area,
among whom the incidence increased from 0.5/100,000 in 1973-1975 to
1.2/100,000 in 1988-1989 (p trend < 0.001). The relative risks (95%
confidence intervals) of anal cancer among never married men compared
with ever married men in the urban areas rose from 5.8 (0.9-8.7) in
1973-1978 to 6.7 (4.7-9.5) in 1979-1984 and 10.3 (7.5-14.1) in 1985-1989
(p trend = 0.02). No significant difference was observed among women. In
conclusion, anal cancer incidence in the United States has increased
significantly during the past 30 years and is now higher in women than
men, in blacks than whites, and in residents of metropolitan rather than
rural areas. Some of this changing pattern clearly relates to the period
prior to the acquired immunodeficiency syndrome (AIDS) epidemic and
argues that behavioral changes are important in anal cancer development.
However, the recent remarkable change in rates among never married men
and men living in the San Francisco Bay area suggests that homosexual
men are at special and increasing risk. The authors speculate whether
part of this recent increase could be attributed to the AIDS epidemic.
DE Adult Aged Aged, 80 and over Anus Neoplasms/*EPIDEMIOLOGY/ETIOLOGY
Confidence Intervals Female Health Behavior Homosexuality Human HIV
Infections/COMPLICATIONS Incidence Male Marital Status Middle Age
Odds Ratio Population Surveillance Registries Risk Factors Rural
Health/TRENDS Sex Factors Sexually Transmitted Diseases/COMPLICATIONS
Support, Non-U.S. Gov't United States/EPIDEMIOLOGY Urban Health/TRENDS
JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).