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Anal High-risk Human Papillomavirus Infection, Squamous Intraepithelial Lesions, and Anal Cancer in Patients with Inflammatory Bowel Disease: A Systematic Review and Meta-analysis

Albuquerque, Andreia; Cappello, Carmelina; Stirrup, Oliver; Selinger, Christian P; (2023) Anal High-risk Human Papillomavirus Infection, Squamous Intraepithelial Lesions, and Anal Cancer in Patients with Inflammatory Bowel Disease: A Systematic Review and Meta-analysis. Journal of Crohn's and Colitis , 17 (8) pp. 1228-1234. 10.1093/ecco-jcc/jjad045. Green open access

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Abstract

BACKGROUND: Ulcerative colitis (UC) and Crohn's disease (CD) can be associated with severe comorbidities, namely opportunistic infections and malignancies. We present the first systematic review and meta-analysis evaluating the burden of anal human papillomavirus disease in patients with UC and CD. METHODS: PubMed, Web of Science and Scopus were searched until November 2022. Meta-analyses were performed using random effects models. The protocol was recorded at PROSPERO register with the number CRD42022356728. RESULTS: Six studies including 78 711 patients with UC with a total follow-up of 518 969 person-years described the anal cancer incidence rate. For anal cancer incidence rate in CD, six studies were selected including 56 845 patients with a total follow-up of 671 899 person-years. The incidence of anal cancer was 10.2 (95%CI 4.3-23.7) per 100 000 person-years in UC and 7.7 (3.5-17.1) per 100 000 person-years in CD. A subgroup analysis of anal cancer in perianal CD including 7 105 patients was calculated with incidence of 19.6 (12.2-31.6) per 100 000 person-years (three studies included). Few studies described prevalence of anal cytological abnormalities (four studies including 349 patients), and high-risk human papillomavirus (three studies including 210 patients), with high heterogeneity. Prevalence of cytological abnormalities or high-risk human papillomavirus was not associated with pharmacological immunosuppression in the studies included. CONCLUSION: The incidence of anal cancer is higher in UC than in CD, with the exception of perianal CD. There is limited and heterogenous data on anal high-risk human papillomavirus infection and squamous intraepithelial lesions prevalence in this population.

Type: Article
Title: Anal High-risk Human Papillomavirus Infection, Squamous Intraepithelial Lesions, and Anal Cancer in Patients with Inflammatory Bowel Disease: A Systematic Review and Meta-analysis
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1093/ecco-jcc/jjad045
Publisher version: https://doi.org/10.1093/ecco-jcc/jjad045
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.
Keywords: anal cancer, Crohn’s disease, ulcerative colitis
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/10167102
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