Abstract:
Importance:In the US, incidence of and mortality due to anal carcinoma are rising faster than for most other cancers. Identifying populations who have a higher risk of developing anal cancers is critical to target preventive interventions. Objective:To assess the risk of developing anal carcinoma in adults living with HIV who have a history of anogenital warts. Design, Setting, and Participants:This longitudinal cohort study included adults living with HIV from 14 clinics in Washington, DC, and at least 18 months of follow-up. Data were collected from January 1, 2011, to March 31, 2017, and analyzed from June 1, 2019, to October 31, 2020. Exposures:Development of warts in the anal or genital region identified by diagnosis codes. Main Outcomes and Measures:Individuals with anal carcinoma were identified by diagnosis codes or anal biopsy results. Results:A total of 6515 participants were enrolled (4720 male [72.4%] at birth; mean [SD] age, 49.9 [12.7] years), and 383 (5.9%) developed anogenital warts during the study period. Patients who were diagnosed with anogenital warts were more likely to subsequently develop anal carcinoma (17 of 383 [4.4%]) compared with participants without a history of anogenital warts (17 of 6132 [0.3%]) (P < .001). After adjusting for covariates, the odds of developing anal carcinoma were 12.79 (95% CI, 6.19-26.45; P < .001) times higher in individuals with a history of anogenital warts compared with individuals without a history of anogenital warts. Conclusions and Relevance:These findings suggest that adults living with HIV who have a history of anogenital warts have a substantially increased risk of developing anal carcinoma. Clinicians should counsel individuals living with HIV who have anogenital warts on this risk.
journal_name
JAMA Dermatoljournal_title
JAMA dermatologyauthors
Arnold JD,Byrne ME,Monroe AK,Abbott SE,District of Columbia Cohort Executive Committee.doi
10.1001/jamadermatol.2020.5252subject
Has Abstractpub_date
2021-01-13 00:00:00eissn
2168-6068issn
2168-6084pii
2774799pub_type
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