Peter V. Chin-Hong, MD; Nancy A. Hessol, MSPH; Joel M. Palefsky, MD
Potential Financial Conflicts of Interest: None disclosed.
Chin-Hong P., Hessol N., Palefsky J.; Is There a Proven Link Between Anal Cancer Screening and Reduced Morbidity or Mortality?. Ann Intern Med. 2009;150:284-285. doi: 10.7326/0003-4819-150-4-200902170-00021
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Published: Ann Intern Med. 2009;150(4):284-285.
We appreciate Dr. Katz and colleagues' comments and their efforts to draw attention to this important issue. They are correct: The incidence of anal cancer is not decreasing. Indeed, published data show that the incidence of invasive anal cancer is increasing in men and women worldwide. In a recent review of 39 population-based registries in the United States between 1998 and 2003, invasive anal cancer increased 2.6% per year on average (1). Using California Cancer Registry data, Cress and Holly (2) used age-adjusted incidence rates from 1973 to 1999 (beginning before the period analyzed by Dr. Katz and colleagues) to show that, among Hispanic and non-Hispanic white men in San Francisco County, age-adjusted rates of invasive anal cancer tripled from 1.5 per 100 000 persons in 1973 to 1978 to 4.5 per 100 000 persons in 1991 to 1995. Dr. Katz and colleagues' data are consistent with Cress and Holly's data for the period they reviewed (beginning in 1988) and show a further increase in incidence of invasive anal cancer to almost 10 per 100 000 persons by 2004 to 2005.
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