Perineal squamous cell cancer in a patient with fistulizing and ulcerating Crohn's disease

Fox, Lindy P.; Pasternack, Fiona R.; Geyer, A; Grossman, Marc E.

doi:10.1111/j.1365-2230.2005.01884.x

Cited by 11 publications

(3 citation statements)

References 4 publications

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“…Consistent with this result, we observed with higher statistical precision a 3‐fold increased risk of anal SCC in patients with an unambiguous diagnosis of Crohn's disease. In previously reported cases, median duration of Crohn's disease before anal SCC was 18 years, and in 79% of patients the anal SCC occurred at least 10 years after initial diagnosis of Crohn's disease 25, 27, 38–52. Our finding of a high SIR of anal SCC also 10 or more years after the first hospital diagnosis of Crohn's disease is consistent with a long‐term effect 47.…”

Section: Discussionsupporting

confidence: 88%

“…Be that as it may, anal SCC complicating Crohn's disease is uncommon. We observed only 1 case of anal SCC per 25,000 person‐years of observation and, to date, only 29 such cases of in situ 38, 39 or invasive25, 27, 40–52 anal SCC have been reported in the literature.…”

Section: Discussionmentioning

confidence: 62%

“…First, a direct carcinogenic effect of immunosuppressive drugs cannot be excluded,59 though this does not explain the increased risk among HIV patients. Second, long‐lasting perianal disease has been reported in the majority of anal SCC patients with Crohn's disease25, 38, 39, 41–47, 49–52 suggesting inflammatory anal lesions per se are responsible for the development of anal SCC. One study reported a higher proportion of HPV‐positive anal SCCs in women with a history of anal fissure or fistula, and it was proposed that inflammatory lesions might promote HPV‐initiated carcinogenesis or facilitate access of HPV to the epithelium 26.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Immunosuppressive disorders and risk of anal squamous cell carcinoma: A nationwide cohort study in Denmark, 1978–2005

Gotschalck

Nørgaard

Thorlacius‐Ussing

et al. 2010

Intl Journal of Cancer

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Compromised immune function may increase the risk of anal squamous cell carcinoma (SCC). We examined the risk of anal SCC in patients with HIV infection and other chronic disorders associated with immunosuppression. A population‐based cohort study was conducted using the Danish National Patient Registry and the Danish Cancer Registry (DCR). We identified all patients with a first‐time hospital contact or procedure for HIV infection, solid organ transplantation or autoimmune disease or a first‐time record of haematologic malignancy in the DCR, 1978–2005, and followed these for a subsequent anal SCC, starting follow‐up 1 year after diagnosis of the index disease. Standardised incidence ratios (SIRs) were computed as the ratio of observed to expected numbers of anal SCCs, based on national age‐, sex‐ and period‐specific rates. Among 4,488 patients with HIV, we observed 21 anal SCCs with 0.3 expected (SIR: 81.1 (95% confidence interval (CI): 51.6–121.9)). Risk of anal SCC was markedly increased among 5,113 solid organ recipients (SIR: 14.4 (CI: 7.0–26.4)) and 30,165 patients with haematologic malignancies (SIR: 2.3 (CI: 1.1–4.2)) but only moderately increased among 242,114 patients with autoimmune diseases (SIR: 1.3 (CI: 1.0–1.6)). SIRs varied according to type of autoimmune disease and were high in patients with Crohn's disease (SIR: 3.1 (CI: 1.2–6.4)), psoriasis (SIR: 3.1 (CI: 1.8–5.1)), polyarteritis nodosa (SIR: 8.8 (CI: 1.5–29.0)) and Wegener's granulomatosis (SIR: 12.4 (CI: 2.1–40.8)). In conclusion, we found HIV infection, solid organ transplantation, haematologic malignancies and a range of specific autoimmune diseases strongly associated with increased risk of anal SCC.

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