title: Anal cancer incidence and mortality in Puerto Rico.
abstract: OBJECTIVE
  Anal cancer is a rare tumor that is associated with oncogenic HPV genotypes. This study aims to compare the age-standardized rates (ASRs) of anal cancer incidence and mortality in men and women living in Puerto Rico (PR) with those of non-Hispanic whites (NHW), non-Hispanic blacks (NHB), and Hispanics (USH) living in the continental United States (US).
  
  
  METHODS
  ASRs were calculated based on cancer data that came from the PR Cancer Central Registry and from the Surveillance, Epidemiology, and End Results (SEER) program. The age-specific relative risks (RR) and 95% Confidence Interval (95% CI) were estimated using Poisson regression models.
  
  
  RESULTS
  Comparing the period of 2001 to 2004 to that of 1992 to 1996, the incidence of anal cancer increased among NHW, NHB, and PR men. In females, an increase in the incidence was observed for all racial groups except for Puerto Rican women. When evaluating findings by age groups, Puerto Rican men younger than 60 years old had a 20% higher incidence of anal cancer than did USH men of the same age strata (RR: 2.20; 95% CI = 1.48-3.29). However, Puerto Rican females had a lower incidence of anal cancer than NHW and NHB women. An increased percent change in mortality was observed only in NHW and NHB men. A decreasing trend was observed in all racial/ethnic groups except for NHW women.
  
  
  CONCLUSIONS
  Our results support the notion that there are racial/ethnic differences in anal cancer incidence and mortality, with potential disparities among men and women in PR compared with USH men and women. Given the increasing incidence trends in anal cancer, particularly among PR, NHW, and NHB men, further investigation is needed to better elucidate screening practices that can aid in the prevention of anal cancer.
authors.affiliation: Department of Health Services Administration, Graduate School of Public Health, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico. vivian.colon@upr.edu
authors.forename: Vivian
authors.initials: V
authors.lastname: Colón-López
authors.forename: Ana P
authors.initials: AP
authors.lastname: Ortiz
authors.forename: Marievelisse
authors.initials: M
authors.lastname: Soto-Salgado
authors.forename: Mariela
authors.initials: M
authors.lastname: Torres-Cintrón
authors.forename: Juan José
authors.initials: JJ
authors.lastname: Mercado-Acosta
authors.forename: Erick
authors.initials: E
authors.lastname: Suárez
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001005:Anus Neoplasms / Q000453:epidemiology* / Q000208:ethnology / Q000401:mortality; D044383:Black People / Q000706:statistics & numerical data; D016001:Confidence Intervals; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D011647:Puerto Rico / Q000453:epidemiology / Q000208:ethnology; D012042:Registries; D012306:Risk; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology; D035862:Vulnerable Populations; D044465:White People / Q000706:statistics & numerical data; D001741:Black or African American