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The impact of gender and HPV status on anal squamous cell carcinoma survival

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Background

Anal cancer is a rare entity and the effect of gender and HPV status on survival is controversial. We aimed to evaluate the difference in overall survival (OS) according to gender and analyzed the effect of HPV status on OS.

Patients and methods

The National Cancer Database (NCDB) was queried for patients with anal squamous cell carcinoma between 2004 and 2016. We evaluated the OS based on gender and HPV status using Kaplan-Meier estimates and we used multivariate Cox regression analyses to evaluate factors associated with overall survival.

Results

A total of 6133 patients with known HPV status were included for analysis. In the non-metastatic group, male gender was associated with worse OS (HR 1.50, 95% CI 1.32–1.70; P<0.001) whereas HPV status did not affect the OS (HR 1.08, 95% CI 0.96–1.22; P=0.213). In the metastatic group, there was no difference in OS based on gender (HR 1.29, 95% CI 0.91–1.82; P=0.148), whereas HPV-negative status was associated with worse OS (HR 1.52, 95% CI 1.09–2.12; P=0.014).

Conclusion

Females had better OS only in non-metastatic anal squamous cell carcinoma (ASCC). HPV-negative status was associated with worse OS only in metastatic ASCC.

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Data availability

The data we used in this study is available from the National Cancer Database.

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Author information

Authors and Affiliations

  1. Department of Hospital Medicine, Cleveland Clinic Foundation, 9500 Euclid Ave, M75, Cleveland, OH, 44195, USA

    Firas Baidoun

  2. Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, OH, USA

    Anas M. Saad

  3. Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada

    Omar Abdel-Rahman

Authors
  1. Firas Baidoun
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  2. Anas M. Saad
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  3. Omar Abdel-Rahman
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Contributions

Firas Baidoun: data analysis, data interpretation, manuscript writing.

Anas M. Saad: manuscript editing, critical revision.

Omar Abdel-Rahman: study concept, manuscript editing, critical revision.

Corresponding author

Correspondence to Firas Baidoun.

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The authors declare no competing interests.

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Article highlights

• Anal cancer is a rare malignancy and anal squamous cell carcinoma (ASCC) accounts for about 80% of it.

• Human papillomavirus (HPV) is the most common risk factor associated with ASCC.

• The prognostic effect of HPV status in ASCC is still controversial and not well-established.

• There are increasing data about gender disparity in ASCC prognosis, but still conflicting and controversial.

• We found that females had better OS only in non-metastatic ASCC, whereas HPV-negative status was associated with worse OS only in metastatic ASCC.

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Baidoun, F., Saad, A.M. & Abdel-Rahman, O. The impact of gender and HPV status on anal squamous cell carcinoma survival. Int J Colorectal Dis 36, 2093–2109 (2021). https://doi.org/10.1007/s00384-021-03910-0

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  • DOI: https://doi.org/10.1007/s00384-021-03910-0

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