Squamous anal cancer: patient characteristics and HPV type distribution.

BACKGROUND: Infection with high risk human papillomavirus (HPV) is strongly associated with anal cancer. However, detailed studies on HPV type distribution by gender and age are limited. METHODS: Retrospective study of 606 invasive anal cancers diagnosed between 1990 and 2005 in two large urban areas of the province of Québec, Canada. Cases were identified from hospitalization registry. Patient characteristics were collected from medical files. Archived anal squamous cancer specimens were available from 96 patients and were tested for HPV DNA and typing. Variant analysis was performed on 16 consecutive and 24 non-consecutive HPV16-positive samples to assess potential contamination during amplification. RESULTS: Among the 606 patients with anal cancers, 366 (60%) were women. Median age at diagnosis was 63 years. HPV was detected in 88/96 (92%) of cases. HPV16 was the most frequent type detected in 90% of HPV-positive specimens. Other types including 6, 11, 18, 33, 52, 53, 56, 58, 62 and 82 were also found. HPV 97 was not detected. HPV prevalence was associated with female gender and younger age. No contamination occurred during amplification as shown by the subset of 41 HPV16-positive samples, as 37, 2 and 1 isolates were from the European, African and Asian lineages, respectively. The most frequent variants were G1 (n=22) and the prototype (n=12). CONCLUSIONS: Women with anal cancer are at higher risk for anal HPV infection, and HPV infection, especially HPV16, is strongly associated with squamous anal cancer. Therefore, HPV vaccine could potentially prevent the occurrence of anal cancer in both men and women.

Impact of diabetes and gender on survival after acute myocardial infarction in the Province of Quebec, Canada--a population-based study.

AIMS: To examine the impact of diabetes, gender and their interaction on 30-day, 1-year and 5-year post-acute myocardial infarction (AMI) mortality in three age groups (20-64, 65-74 and > or = 75 years). METHODS: Retrospective analysis including 23 700 patients aged > or = 20 years (22% with diabetes) admitted to hospital for a first AMI in any hospital in the Province of Quebec, Canada, between April 1995 and March 1997. Administrative databases were used to identify patients and assess outcomes. RESULTS: Regarding 30-day mortality, there was non-significant interaction between diabetes and gender. Women aged < 75 years had, independently of diabetes status, at least a 38% (P < 0.05) higher mortality than their male counterparts after adjustment for socio-economic status and co-morbid conditions. Gender difference disappeared, however, after controlling for in-hospital complications. Regarding 1-year mortality (31-365 days), there was no significant gender disparity for all age groups. During the 5-year follow-up, no gender differences were seen in any age group, except for younger (< 65 years) women with diabetes, who had a 52% (P = 0.004) higher mortality than men after controlling for co-variables. This female disadvantage was demonstrated by a significant interaction between diabetes and gender in patients aged < 65 years (P = 0.009). CONCLUSIONS: The higher 30-day mortality post-AMI in younger (20-64 years) and middle-aged (65-74 years) women compared with men was not influenced by diabetes status. However, during the 5-year follow-up, the similar gender mortality observed in patients without diabetes seemed to disappear in younger patients with diabetes, which may be explained by the deleterious, long-term, post-AMI impact of diabetes in younger women.