Race Is Associated With Burden of Anal Condyloma and Need for Operative Intervention. J Surg Res 2018 Dec;232:629-634
Date
11/23/2018Pubmed ID
30463783DOI
10.1016/j.jss.2018.07.020Scopus ID
2-s2.0-85051385217 (requires institutional sign-in at Scopus site) 2 CitationsAbstract
BACKGROUND: Human papillomavirus is a common sexually transmitted infection that may affect the oropharynx, genitalia, or anus. Some strains of this virus may cause bulky growths around the anus known as giant anal condylomas. These can become large, disfiguring, and may cause bleeding, as well as difficulty with defecation and hygiene. Surgical management is usually necessary for large condylomas, whereas office-based procedures are common for smaller lesions. It is unclear why some develop large anal margin tumors, whereas others develop limited disease. The aim of the present study was to evaluate for risk factors that may play a role in the development of extensive disease warranting operative management.
MATERIALS AND METHODS: A retrospective chart review of patients seen within the Anal Dysplasia Clinic at the Medical College of Wisconsin was undertaken. Clinic encounters for patients with anogenital condyloma were abstracted for demographic information, operative interventions, Human Immunodeficiency Virus status, and smoking history to determine risk factors that predicted operative intervention for giant anal condylomas.
RESULTS: A total of 239 patients met inclusion criteria; 211 (88.3%) were male and 28 (11.7%) were female. Racial makeup of the cohort included 49% Caucasian, 38.9% African-American, 9.2% Hispanic, and 2.9% were identified as another ethnicity. One hundred forty-three patients (60.1%) were current or past smokers. One hundred ninety-eight (82.8%) patients tested positive for human immunodeficiency virus (HIV), whereas 41 (17.2%) were negative. Multiple linear regression identified only African-American race as predictive of greater disease burden.
CONCLUSIONS: African-American race was associated with increased size of anal condyloma. As the size of anal condylomas increase, management shifts from topical treatments to operative intervention. This is the first study to correlate race with burden of disease in the general population.
Author List
Foss HE, Blank JJ, Lundeen SJ, Peterson CY, Ludwig KA, Ridolfi TJAuthors
Jacqueline Blank MD Assistant Professor in the Surgery department at Medical College of WisconsinKirk A. Ludwig MD Chief, Professor in the Surgery department at Medical College of Wisconsin
Sarah J. Lundeen NP APP Outpatient in the Surgery department at Medical College of Wisconsin
Carrie Peterson MD, MS, FACS, FASCRS Associate Professor in the Surgery department at Medical College of Wisconsin
Timothy J. Ridolfi MD, MS, FACS Associate Professor in the Surgery department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdolescentAdult
Aged
Aged, 80 and over
Anus Diseases
Condylomata Acuminata
Cost of Illness
Female
HIV
Humans
Logistic Models
Male
Middle Aged
Retrospective Studies
Young Adult
