Anal cancer in renal transplant patients

• Published in: International journal of colorectal disease Vol. 22; no. 1; pp. 1 - 5
• Main Authors: PATEL, Heena S, SILVER, Andrew R. J, NORTHOVER, John M. A
• Format: Journal Article
• Language: English
• Published: Heidelberg Springer 01.01.2007; Berlin Springer Nature B.V
• Subjects: Anus Diseases - epidemiology; Anus Diseases - virology; Anus Neoplasms - epidemiology; Anus Neoplasms - etiology; Biological and medical sciences; Carcinoma in Situ - epidemiology; Carcinoma in Situ - etiology; Gastroenterology. Liver. Pancreas. Abdomen; Graft Rejection - complications; Graft Rejection - prevention & control; Humans; Immunosuppression - adverse effects; Immunosuppressive Agents - adverse effects; Kidney Failure, Chronic - surgery; Kidney Transplantation; Kidneys; Medical sciences; Nephrology. Urinary tract diseases; Papillomavirus Infections - epidemiology; Papillomavirus Infections - etiology; Prevalence; Risk Factors; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the urinary system; Tumors; Tumors of the urinary system; Rhône Alpes; France; Europe; Ain; Papovaviridae; Papillomavirus; Human papillomavirus; Gastroenterology; Intestinal disease; Anorectal disease; Kidney disease; Human; Immunopathology; Dysplasia; Urinary system disease; Anal cancer; AIDS; Malignant tumor; Medical screening; Immune deficiency; Anal cancer, Anal dysplasia, Screening; Infection; Virus; Anus; Viral disease; Kidney cancer; Renal transplantation; Digestive diseases; Intraepithelial neoplasia; Kidney transplantation
• ISSN: 0179-1958; 1432-1262
• DOI: 10.1007/s00384-005-0023-3

A comprehensive literature review was performed to examine the prevalence of anal cancer, anal intraepithelial neoplasia (AIN) and anal human papillomavirus (HPV) infection in renal transplant recipients who are at risk of anal cancer due to iatrogenic immunosuppression. Pertinent articles were identified from searches performed on the National Center for Biotechnology Information database using the following keywords: anal cancer, AIN, screening, renal transplant (or kidney transplant), organ transplant recipients and post-transplant malignancies. The prevalence of AIN is 20% in renal transplant patients. The prevalence of anal HPV infection in established transplant patients is 47%, and the prevalence of anal HPV infection in new transplant patients is 23%. The relative risk for anal cancer in renal transplant patients is 10. As compared to HIV-positive male patients who practise anal intercourse, renal transplant patients showed a modest rise in relative risk for anal cancer. Screening programmes to detect AIN in HIV-positive patients who practise anal intercourse have been introduced on a preliminary basis in sexual health clinics in the US and may become standard practise in this population. The case for screening in renal transplant patients is unclear and would merit further investigation, especially with reference to the prevalence of anal HPV infection in this population. It may transpire that renal transplant patients would benefit more from HPV prophylaxis rather than screening for AIN.