Most Anal Lesions Don’t Cause Cancer in Men, Research Shows

FRIDAY, March 23 (HealthDay News) — Anal human papillomavirus
(HPV) infection and precancerous lesions are common among gay and bisexual
men, but most of these cases will not progress to anal cancer, a new
analysis of earlier research shows.

The researchers also found that the rate of progression from anal
lesions to anal cancer among men appears to be much lower than the rate of
progression from cervical lesions to cervical cancer among women.

Types HPV 16 and HPV 18 cause 80 percent of anal cancers and 70 percent
of cervical cancers, according to background information in the report,
published online March 22 in The Lancet Oncology.

In the study, the researchers analyzed data from 53 previous studies
involving gay and bisexual men and found that most of the men had anal HPV
infection, and 20 percent to 30 percent of them had precancerous anal
lesions.

HIV-positive men were much more likely to be infected with high-risk
HPV types than HIV-negative men (73 percent vs. 37 percent) and were also
more likely to have precancerous anal lesions, the investigators
noted.

The progression rate from high-grade anal lesions to anal cancer was
about one in 600 per year for HIV-positive men and about one in 4,000 per
year for HIV-negative men. In comparison, the progression rate from
high-grade cervical lesions to cervical cancer is about one in 80 per
year.

Because cervical cancer screening has led to sharp decreases in
cervical cancer cases and deaths, it’s been suggested that the same
screening strategies for precancerous anal lesions in gay and bisexual men
could save many lives. However, these findings indicate it’s not that
simple, lead author Andrew Grulich, of the University of New South Wales
in Australia, explained in a journal news release.

“The substantial differences in the natural history of anal HPV
infection to those of cervical HPV infection that this review has
identified suggests that we cannot simply transfer cervical cancer
screening strategies to anal cancer screening,” Grulich and colleagues
concluded.

“Large, good-quality prospective studies are needed to inform the
development of anal cancer screening guidelines for [men who have sex with
men],” the authors suggested.

More information

The American Cancer Society has more about anal cancer.

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