Sex differences in the incidence and clearance of anal human papillomavirus infection among heterosexual men and women in Liuzhou, China: An observational cohort study. Issue 3 (22nd March 2019)

• Record Type: Journal Article
• Authors: Wei, Feixue; Su, Yingying; Yao, Xingmei; Cui, Xuelian; Bian, Lihong; Yin, Kai; Yu, Xiaojuan; Zhuang, Chunlan; Bi, Zhaofeng; Huang, Shoujie; Li, Mingqiang; Wu, Ting; Xia, Ningshao; Zhang, Jun
• Is Part Of: International journal of cancer. Volume 145:Issue 3(2019)
• Page Start: 807
• Page End: 816
• Publication Date: 2019-03-22
• Subjects: HPV -- incidence -- clearance -- anal cancer -- sexes; Cancer -- Periodicals; Cancer -- Prevention -- Periodicals; 616.994
• DOI: 10.1002/ijc.32255
• Languages: English
• ISSNs: 0020-7136

Abstract

Abstract : Anal cancer is primarily caused by human papillomavirus (HPV) infection in both men and women. However, little is known about the sex differences in the natural history of anal HPV infection in a heterosexual population. From May 2014 to March 2016, perianal/anal canal (PA) swab samples were collected semiannually from 2, 302 heterosexual men and 2, 371 heterosexual women aged 18–55 years old in Liuzhou, China. The specimens were genotyped for HPV DNA by polymerase chain reaction. The incidence rate ratio (IRR) and clearance rate ratio (CRR) were used to analyze the sex differences of incidence and clearance by Poisson regression, respectively. The incidences of PA oncogenic HPV in men and women were 3.4 per 1, 000 person‐months and 8.6 per 1, 000 person‐months, respectively, with an IRR of 0.39 (95% confidence interval (CI), 0.29–0.54 for men versus women) ( p < 0.0001). The CRR of PA oncogenic HPV infection for men versus women was 1.54 (95% CI, 1.17–2.03) ( p = 0.0022). At 12 months, 44% (20/45) of HPV 16/18 infections among women remained positive, whereas no (0/7) infections persisted among men ( p = 0.0350). Both the higher incidence and slower clearance of anal carcinogenic HPV infection among women may lead to a higher burden of anal cancer among women than among men in a heterosexual population. Abstract : What's new? While human papillomavirus (HPV) infection is a major cause of anal cancer in men and women, anal cancer incidence differs between the sexes. The dynamics of anal HPV infection in the general heterosexual population, however, are not well understood. Here, women were found to have a higher risk of acquiring anal carcinogenic HPV infection than men based on follow‐up and analysis of perianal/anal canal specimens for approximately 4, 000 heterosexual Chinese men and women. Women were also found to have a lower likelihood of clearing anal HPV infection. These differences potentially contribute to increased anal cancer burden in women.