Document 0184
 DOCN  M9460184
 TI    Changing patterns of anal cancer incidence in the United States,
       1940-1989.
 DT    9408
 AU    Melbye M; Rabkin C; Frisch M; Biggar RJ; Danish Epidemiology Science
       Centre, State Serum Institute,; Copenhagen.
 SO    Am J Epidemiol. 1994 Apr 15;139(8):772-80. Unique Identifier : AIDSLINE
       MED/94234106
 AB    Anal cancer has been hypothesized to be associated with a sexually
       transmitted agent and, more recently, with the epidemic of human
       immunodeficiency virus (HIV). The authors used a descriptive incidence
       study to evaluate these hypotheses based on US data from the
       Surveillance, Epidemiology, and End Results (SEER) program for 1973-1989
       and from the Connecticut Tumor Registry for 1940-1988. Since 1960, anal
       cancer incidence in Connecticut increased 1.9-fold among men and
       2.3-fold among women. Based on information from SEER, the incidence was
       lowest among white men (1973-1989 average: 0.41/100,000) and highest
       among black women (1973-1989 average: 0.74/100,000). Residents of the
       metropolitan areas had a twofold risk of anal cancer compared with
       populations in less densely populated areas. The most dramatic change in
       incidence was observed for white men in the San Francisco Bay area,
       among whom the incidence increased from 0.5/100,000 in 1973-1975 to
       1.2/100,000 in 1988-1989 (p trend < 0.001). The relative risks (95%
       confidence intervals) of anal cancer among never married men compared
       with ever married men in the urban areas rose from 5.8 (0.9-8.7) in
       1973-1978 to 6.7 (4.7-9.5) in 1979-1984 and 10.3 (7.5-14.1) in 1985-1989
       (p trend = 0.02). No significant difference was observed among women. In
       conclusion, anal cancer incidence in the United States has increased
       significantly during the past 30 years and is now higher in women than
       men, in blacks than whites, and in residents of metropolitan rather than
       rural areas. Some of this changing pattern clearly relates to the period
       prior to the acquired immunodeficiency syndrome (AIDS) epidemic and
       argues that behavioral changes are important in anal cancer development.
       However, the recent remarkable change in rates among never married men
       and men living in the San Francisco Bay area suggests that homosexual
       men are at special and increasing risk. The authors speculate whether
       part of this recent increase could be attributed to the AIDS epidemic.
 DE    Adult  Aged  Aged, 80 and over  Anus Neoplasms/*EPIDEMIOLOGY/ETIOLOGY
       Confidence Intervals  Female  Health Behavior  Homosexuality  Human  HIV
       Infections/COMPLICATIONS  Incidence  Male  Marital Status  Middle Age
       Odds Ratio  Population Surveillance  Registries  Risk Factors  Rural
       Health/TRENDS  Sex Factors  Sexually Transmitted Diseases/COMPLICATIONS
       Support, Non-U.S. Gov't  United States/EPIDEMIOLOGY  Urban Health/TRENDS
       JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).