Clinicopathological aspects and prevalence of human papillomavirus in anal cancer

Abstract

Anal cancer is relatively rare; however, its incidence has increased in recent years. Several risk factors are associated with the development of anal cancer, including age older than 50 years, low-fiber diet, chronic anal fistulas, smoking, multiple partners, anal intercourse practice, Human Immunodeficiency Virus infection and immunosuppression. However, the presence of human papillomavirus represents the main risk factor for the development of anal cancer. The aim of this study was to evaluate the clinicopathological aspects of a series of patients with anal carcinomas diagnosed in Hospital Araújo Jorge, Goiânia-Goiás, as well as the prevalence of human papillomavirus genome in these tumors. Clinical, pathological and socio-demographic data were collected from the respective medical files and paraffin blocks containing anal carcinomas specimens were used for DNA extraction and detection of human papillomavirus, by means of polymerase chain reaction, using short PCR fragment primers. Forty-three cases were selected and had the data analyzed, while 38 cases were tested for human papillomavirus genome detection. Among the evaluated patients, 62.8% were women; 53.4% of tumors were squamous cell carcinoma and 46.5% of the patients were aged between 60 and 75 years. Risk factors, such as smoking (39.5%) and alcoholism (20.9%) were recorded in the studied group. Lymph node metastases were detected in 30.2% of cases and 7.0% had distant metastasis. The detection of human papillomavirus DNA was positive in 76% of cases assessed and this was significantly associated with squamous cell carcinomas. Aggressive behavior and advanced stage of anal cancer described in this study highlight the need for preventive measures that contemplate these tumors, including vaccination against human papillomavirus.

Prevalence of human papillomavirus infection in squamous cell carcinoma of the anal canal in a Northeast City in Brazil: viral genotyping and clinical aspects

“…Ouhoummanea and co-authors [8] found that the majority of incidence of anal cancer (60%) was in women. Aguiar and colleagues found that 62.8% of patients with anal cancer were women [9]. The results of a study of Czech patients with anal cancer by Tachezy et al [6], in which the same number of patients was analyzed as in our study, revealed that 52.4% of the patients were female.…”

“…According to several researches, the peak incidence of anal cancer is between the ages of 58 and 64 years [6][7][8][9][10]. The mean age of patients with anal cancer may had vary among studies, possibly because of the type of population studied and the presence of risk factors such as sexual orientation, immunosuppression (patients with HIV+ infection and transplant recipients), tobacco smoking, and alcoholism [6][7][8][9][10].…”

“…The prevalence of HPV infection for each continent was 87.6, 95.8, 90.4, 61.9, and 81.1%, respectively [10]. In Brazil, Aguiar and coauthors conducted a study of patients with anal carcinomas in Goiânia-Goiás, and found that 76.3% of the samples collected were positive for HPV [9]. The results of our study also corroborate the findings of Varnai and colleagues [11], Ramamoorthy and colleagues [12], de Vuyst and colleagues [13], and Rodel and colleagues [14], who reported the detection of HPV-DNA presence in 60.6, 80, 73, and 95.8% of anal cancer samples examined, respectively.…”

Using simulation as cervical and anal cytology teaching-learning strategy

“…This strategy allows identifying neoplastic changes at early stages and enables early treatments. Current recommendations indicate anal screening for at-risk groups, including individuals who practice receptive anal sex, people living with HIV/AIDS, and those with a history of anogenital malignancies caused by human papillomavirus (HPV) [20,21].…”

Human Papillomavirus and Anal Cancer: Prevalence, Genotype Distribution, and Prognosis Aspects from Midwestern Region of Brazil

“…According to the Population Based Cancer Registry of Goiânia, between 1989 and 2008, a total of 117 cases of anal cancer were diagnosed in the city, but more recent data were not available. A study carried out in Goiânia, a city in the Midwest region of Brazil, described 42 cases of anal cancer, of which 38 were tested for HPV DNA and 76% were positive for the presence of HPV DNA [12].…”