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High-risk human papilloma virus, precancerous lesions and cancer in anal condylomas

Andreia, A; Cappello, C; Stirrup, O; (2021) High-risk human papilloma virus, precancerous lesions and cancer in anal condylomas. AIDS , 35 (12) pp. 1939-1948. 10.1097/QAD.0000000000002975. Green open access

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Abstract

INTRODUCTION: anal condylomas are associated with human papillomavirus (HPV) infection and are a risk factor for anal squamous cell carcinoma (SCC). OBJECTIVE: to conduct a meta-analysis evaluating the prevalence of anal high-risk-HPV, high-grade squamous intraepithelial lesions (HSIL) and SCC in patients with condylomas. The standardised incidence ratio (SIR) and the incidence rate (IR) of anal SCC were also calculated. METHODS: three electronic databases were searched until April 2020. Meta-analyses were performed using random effects models. RESULTS: pooled prevalence estimate of HR-HPV in anal condylomas was 40.2% (21.0 - 63.1) in immunocompromised and 16.4% (10.7 - 24.3) in non-immunocompromised patients, with an odds ratio (OR) of 3.79 (1.51-9.52, P = 0.005) for immunocompromised patients. HR-HPV in condylomas with HSIL was 73.8% (39.1 - 92.5) and in non-HSIL cases was 17.7% (9.6 - 30.2), corresponding to an OR of 12.33 (2.97-51.21, P = 0.001) for those with HSIL. The prevalence of HSIL in condylomas was 24.0% (16.4 - 33.7) in immunocompromised and 11.8% (7.2 - 18.8) in non-immunocompromised patients, with an OR of 2.51 (1.72-3.65, P < 0.001) for immunocompromised patients. The overall prevalence of anal SCC was 0.3% (0.0 - 1.7). The SIR of anal SCC was 10.7 (8.5 - 13.5), 20.1 (14.4 - 28.2) in men and 7.7 (5.6 - 10.5) in women. The overall IR of anal SCC was 6.5 per 100 000 persons-year (3.6 - 11.7), 12.7 (9.1 - 17.8) in men and 4.7 (1.7 - 13) in women. CONCLUSION: patients with a history of anal condylomas have a high risk of anal SCC, especially men. The prevalence of HR-HPV and HSIL in condylomas from immunocompromised patients is high. This information can change patient follow-up and treatment.

Type: Article
Title: High-risk human papilloma virus, precancerous lesions and cancer in anal condylomas
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1097/QAD.0000000000002975
Publisher version: https://doi.org/10.1097/QAD.0000000000002975
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health > Infection and Population Health
URI: https://discovery.ucl.ac.uk/id/eprint/10129494
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