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Human Papillomavirus Antibodies Differ in Men and Women with Anal Cancer
Garg R1,2, Carter JJ2, Johnson LG2, Schwartz SM1,2, Daling JR2, Madeleine MM1,2, Galloway DA1,2 1University of Washington and 2Fred Hutchinson Cancer Research Center, Seattle, WA USA INTRODUCTION
Seropositivity for Several HPV Types and Associations with Anal Cancers
54% of cases were seropositive for HPV 16L1 antibodies vs 7% of controls. Among those with anal cancer who were seropositive, the proportion of men exceeded women for 71% of HPVL1 types tested. Adjustment for HPV 16L1 seropositivity negated all significant associations between anal cancer and HPV seropositivity • Receptive anal intercourse• Number lifetime sex partners CONTROLS (n=234)
ANAL CANCER CASES (n=194)
HPV
Sero-
Female
Male Female
Male
• YET—HPV stands out as independent risk factor
Type positivity
OR (95% CI)
OR (95% CI)
9.5 (4.5–20.0)
33.1 (12.4–88.2)
Significant portion anal cancers associated 5.5 (1.8–16.8)
20.9 (2.7–161.2)
5.6 (2.2–14.4)
Case-control study of anal cancer cases from population-basedUS cancer registry participating in NCI’s SEER Program Residents of 3-county area, including Seattle, WA 16.8 (3.8–73.6)
Controls recruited through random-digit dialing and matched Controls
Squamous Cell Cancer
12.2 (1.5–96.4)
(SCC) Anal Cases (n=194)
Blood samples—Luminex assay (GST fusion proteins) (Detailed methods available upon request) 17.1 (5.8–50.6)
38.9 (5.0–302.7)
2.8 (1.1–7.0)
Demographics
CONTROLS
SCC ANAL CASES
Female
Male
Female
Male
Risk of Anal Cancer Association with HPV Seropositivity by # of HPV Types
Age: <40
There was little difference in the risk of anal cancer between women seropositive for 1 HPV type vs 2+ types (0.23, Chi-square test for trend), but there was a trend towards ↑ risk of anal cancer among men seropositive for 1 type vs. 2+ types (p<0.001).
Race/Ethnicity
White
CONTROLS (n=234)
ANAL CANCER CASES (n=194)
# HPV
Female
Male Female
Male
Education: ≤ HS
Types
OR (95% CI)
OR (95% CI)
3.8 (1.7–8.5)
11.4 (4.7–27.7)
Risk of In Situ vs Invasive Anal Cancer Association
Sex Partners: 1
with HPV Seropositivity by # of HPV Types
There was a significant association between ↑ number of HPV types and ↑ risk of in situ, as well as invasive, disease, among men; however, no such association was found among women.
Sexual Behavior
# HPV
Controls In Situ
Invasive
Types
OR (95% CI)
OR (95% CI)
Receptive Anal Sex
7.0 (2.0–24.9)
2.8 (1.1–7.0)
27.1 (7.6–96.4)
6.4 (2.3–17.5)
# HPV
Controls In Situ
Invasive
Types
OR (95% CI)
OR (95% CI)
Seropositivity for Several HPV Types and Associations with In Situ vs Invasive Anal Cancer
Men with in situ cancer were more likely to be HPV 16L1 seropositive than men with invasive disease Male Controls
Female Controls
(p=0.004), whereas men with invasive cancer were more likely to be HPV 16E6 seropositive (p=0.009).
Similarly, women with invasive cancer were more likely to be HPV 16E6 seropositive (p=0.004). The proportion of HPV 16L1 seropositive women was virtually the same among women with in situ (39%) HPV
Sero-
Controls In Situ
Invasive
Type positivity
OR (95% CI)
OR (95% CI)
78.6 (22.2–278.1)
18.2 (6.4–51.8)
19.5 (2.2–176.6)
49.9 (6.3–394.9)
HPV
Sero-
Controls In Situ
Invasive
Type positivity
OR (95% CI)
OR (95% CI)
CONCLUSIONS
9.2 (3.4–24.9)
9.6 (4.4–21.1)
Seropositivity to HPV 16L1 and 16E6 was associated with anal cancer in both men and women.
Seropositivity to multiple oncogenic HPV types was associated with anal cancer in men only.
23.5 (7.9–70.4)
Women reporting 1 partner had a higher prevalence of HPV positivity than men, suggesting 3.1 (1.2–8.2)
a gender-based difference in exposure or immune response.

Source: http://research.fhcrc.org/content/dam/stripe/galloway/files/meetings/Final_HPV_09_Sweden.pdf

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