Skip to main content
PMC home page
The BMJ logoLink to The BMJ
. 1993 Feb 13;306(6875):419–422. doi: 10.1136/bmj.306.6875.419

Trends in incidence of anal cancer in Denmark.

M Frisch 1, M Melbye 1, H Møller 1
PMCID: PMC1676495  PMID: 8461721

Abstract

OBJECTIVE--To study long term trends in incidence of anal cancer in a well monitored, unselected population. DESIGN--Descriptive epidemiological study based on data from the Danish Cancer Registry. SETTING--Denmark, 1943-87. MAIN OUTCOME MEASURES--Time related changes in anal cancer incidence according to sex, age, birth cohort, urban or rural residence, and marital status. RESULTS--The incidence of anal cancer remained fairly constant in the period 1943-57 and was similar for men and women, but it increased 1.5-fold among men and nearly tripled among women thereafter. Among men the incidence increased from 0.25 per 100,000 population (world standardised) in 1958-62 to 0.38 in 1983-7 (p = 0.01) and among women from 0.28 to 0.74 (p < 0.01). The greatest increase was among residents of the capital (Copenhagen). During 1943-87 age specific trends increased in young and middle aged men and in all age groups among women. Men with anal cancer were significantly more likely throughout the study period to be unmarried than were patients with cancer of the colon (adjusted odds ratio 2.7; 95% confidence interval 2.0 to 3.6) and stomach (2.1; 1.5 to 2.8), but no association with marital status was found among women. CONCLUSIONS--The distribution and incidence of anal cancer have changed appreciably since around 1960, especially among women, which indicates important aetiological changes. Changes in sexual behaviour may have facilitated the spread of a transmittable agent of aetiological importance. It has recently been suggested that cigarette smoking promotes anal cancer, and this finds indirect support in the synchronism between changes in anal cancer incidence and heavy smoking behaviour. Factors associated with homosexuality are likely to explain some of the cases among men.

Full text

PDF
420

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Austin D. F. Etiological clues from descriptive epidemiology: squamous carcinoma of the rectum or anus. Natl Cancer Inst Monogr. 1982;62:89–90. [PubMed] [Google Scholar]
  2. Beckmann A. M., Daling J. R., Sherman K. J., Maden C., Miller B. A., Coates R. J., Kiviat N. B., Myerson D., Weiss N. S., Hislop T. G. Human papillomavirus infection and anal cancer. Int J Cancer. 1989 Jun 15;43(6):1042–1049. doi: 10.1002/ijc.2910430615. [DOI] [PubMed] [Google Scholar]
  3. Biggar R. J., Burnett W., Mikl J., Nasca P. Cancer among New York men at risk of acquired immunodeficiency syndrome. Int J Cancer. 1989 Jun 15;43(6):979–985. doi: 10.1002/ijc.2910430605. [DOI] [PubMed] [Google Scholar]
  4. Blohmé I., Brynger H. Malignant disease in renal transplant patients. Transplantation. 1985 Jan;39(1):23–25. [PubMed] [Google Scholar]
  5. Caussy D., Goedert J. J., Palefsky J., Gonzales J., Rabkin C. S., DiGioia R. A., Sanchez W. C., Grossman R. J., Colclough G., Wiktor S. Z. Interaction of human immunodeficiency and papilloma viruses: association with anal epithelial abnormality in homosexual men. Int J Cancer. 1990 Aug 15;46(2):214–219. doi: 10.1002/ijc.2910460212. [DOI] [PubMed] [Google Scholar]
  6. Daling J. R., Sherman K. J., Hislop T. G., Maden C., Mandelson M. T., Beckmann A. M., Weiss N. S. Cigarette smoking and the risk of anogenital cancer. Am J Epidemiol. 1992 Jan 15;135(2):180–189. doi: 10.1093/oxfordjournals.aje.a116270. [DOI] [PubMed] [Google Scholar]
  7. Daling J. R., Weiss N. S., Hislop T. G., Maden C., Coates R. J., Sherman K. J., Ashley R. L., Beagrie M., Ryan J. A., Corey L. Sexual practices, sexually transmitted diseases, and the incidence of anal cancer. N Engl J Med. 1987 Oct 15;317(16):973–977. doi: 10.1056/NEJM198710153171601. [DOI] [PubMed] [Google Scholar]
  8. Daling J. R., Weiss N. S., Klopfenstein L. L., Cochran L. E., Chow W. H., Daifuku R. Correlates of homosexual behavior and the incidence of anal cancer. JAMA. 1982 Apr 9;247(14):1988–1990. [PubMed] [Google Scholar]
  9. Goldman S., Glimelius B., Nilsson B., Påhlman L. Incidence of anal epidermoid carcinoma in Sweden 1970-1984. Acta Chir Scand. 1989 Mar;155(3):191–197. [PubMed] [Google Scholar]
  10. Holmes F., Borek D., Owen-Kummer M., Hassanein R., Fishback J., Behbehani A., Baker A., Holmes G. Anal cancer in women. Gastroenterology. 1988 Jul;95(1):107–111. doi: 10.1016/0016-5085(88)90297-1. [DOI] [PubMed] [Google Scholar]
  11. Mahaney F. X., Jr Fighting cancer with cigarette taxes. J Natl Cancer Inst. 1989 May 10;81(10):726–728. doi: 10.1093/jnci/81.10.726. [DOI] [PubMed] [Google Scholar]
  12. Melbye M., Biggar R. J., Ebbesen P., Sarngadharan M. G., Weiss S. H., Gallo R. C., Blattner W. A. Seroepidemiology of HTLV-III antibody in Danish homosexual men: prevalence, transmission, and disease outcome. Br Med J (Clin Res Ed) 1984 Sep 8;289(6445):573–575. doi: 10.1136/bmj.289.6445.573. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Melbye M., Biggar R. J. Interactions between persons at risk for AIDS and the general population in Denmark. Am J Epidemiol. 1992 Mar 15;135(6):593–602. doi: 10.1093/oxfordjournals.aje.a116338. [DOI] [PubMed] [Google Scholar]
  14. Melbye M., Palefsky J., Gonzales J., Ryder L. P., Nielsen H., Bergmann O., Pindborg J., Biggar R. J. Immune status as a determinant of human papillomavirus detection and its association with anal epithelial abnormalities. Int J Cancer. 1990 Aug 15;46(2):203–206. doi: 10.1002/ijc.2910460210. [DOI] [PubMed] [Google Scholar]
  15. Melbye M., Sprøgel P. Aetiological parallel between anal cancer and cervical cancer. Lancet. 1991 Sep 14;338(8768):657–659. doi: 10.1016/0140-6736(91)91233-k. [DOI] [PubMed] [Google Scholar]
  16. Osler M. Smoking habits in Denmark from 1953 to 1991: a comparative analysis of results from three nationwide health surveys among adult Danes in 1953-1954, 1986-1987 and 1990-1991. Int J Epidemiol. 1992 Oct;21(5):862–871. doi: 10.1093/ije/21.5.862. [DOI] [PubMed] [Google Scholar]
  17. Palefsky J. M., Holly E. A., Gonzales J., Berline J., Ahn D. K., Greenspan J. S. Detection of human papillomavirus DNA in anal intraepithelial neoplasia and anal cancer. Cancer Res. 1991 Feb 1;51(3):1014–1019. [PubMed] [Google Scholar]
  18. Peters R. K., Mack T. M. Patterns of anal carcinoma by gender and marital status in Los Angeles County. Br J Cancer. 1983 Nov;48(5):629–636. doi: 10.1038/bjc.1983.244. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Scholefield J. H., Thornton Jones H., Cuzick J., Northover J. M. Anal cancer and marital status. Br J Cancer. 1990 Aug;62(2):286–288. doi: 10.1038/bjc.1990.279. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Wexner S. D., Milsom J. W., Dailey T. H. The demographics of anal cancers are changing. Identification of a high-risk population. Dis Colon Rectum. 1987 Dec;30(12):942–946. doi: 10.1007/BF02554281. [DOI] [PubMed] [Google Scholar]
  21. zur Hausen H. Papillomaviruses in anogenital cancer as a model to understand the role of viruses in human cancers. Cancer Res. 1989 Sep 1;49(17):4677–4681. [PubMed] [Google Scholar]

Articles from BMJ : British Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES