Etiologic fraction of HPV-attributed anal and penile squamous cell carcinoma: study in specialized hospitals, Sri Lanka

Etiologic fraction of HPV-attributed anal and penile squamous cell carcinoma: study in specialized hospitals, Sri Lanka | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Etiologic fraction of HPV-attributed anal and penile squamous cell carcinoma: study in specialized hospitals, Sri Lanka W D J K Amarasena, Sampatha Goonewardena, K D B M Wijeratne, Vajirapani De Silva, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6897768/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 27 Dec, 2025 Read the published version in BMC Infectious Diseases → Version 1 posted 10 You are reading this latest preprint version Abstract Introduction The Human Papilloma Virus (HPV) infection is known to cause anogenital cancers. Male HPV prevalence and population-attributable risk (PAR)are important to plan future HPV preventive strategies for HPV-driven anogenital cancers in males. Methods A hospital-based case-control study was carried out to determine the etiologic fraction attributed to HPV-driven anal and penile(anogenital) cancers among male patients presenting to tertiary care hospitals in Gampaha district and Apeksha Hospital (cancer specialized), Sri Lanka and to calculate PAR percentage on anogenital SCC among the study population where HPV prevalence was 5.7%. New or already diagnosed patients for anal and penile SCC who reported to selected hospitals from August 2022 to June 2023 were recruited for data and specimen collection. A sample size of 20 cases and 80 controls were selected, with four controls chosen per case from sexually active, clinically normal men aged 20-70 years residing in the Gampaha district. Additional etiological factors that were checked included the presence of sexually transmitted infections, phimosis, anogenital injury, and the use of tobacco, alcohol or illegal drugs. The chi-square test was used at the level p<0.05 significance. Bivariable and logistic regression analyses were used to calculate odds ratios (ORs). Results A significantly associated factor for getting anal and penile SCC was HPV infection (p<0.001; adjusted OR: 27.7; 95% CI: 4.3,177.8).For any HPV genotype & high-risk HPV genotype, prevalence was 55% & 50% among cases and 5% & 2.5% among controls respectively. Assuming prevalence among controls as the population prevalence, the calculated PAR% was 62.2% for any HPV genotype and 33% for the HPV 16 HR genotype. Conclusions Sixty-two per cent of the anal and penile SCCs were attributed to any HPV genotype and one-third of anal and penile SCCs can be prevented by introducing HPV 16 genotype-containing vaccine to male. Penile squamous cell carcinoma Anal squamous cell carcinoma HPV infection Full Text Additional Declarations No competing interests reported. Supplementary Files SupplementaryTables.docx SI2CaseControlStudyquetionareEnglish.docx DataAvailabilityStatementResubmission.pdf Cite Share Download PDF Status: Published Journal Publication published 27 Dec, 2025 Read the published version in BMC Infectious Diseases → Version 1 posted Editorial decision: Revision requested 26 Sep, 2025 Reviews received at journal 17 Sep, 2025 Reviews received at journal 08 Sep, 2025 Reviewers agreed at journal 08 Sep, 2025 Reviewers agreed at journal 08 Sep, 2025 Reviewers invited by journal 29 Aug, 2025 Editor assigned by journal 28 Aug, 2025 Editor invited by journal 06 Aug, 2025 Submission checks completed at journal 05 Aug, 2025 First submitted to journal 05 Aug, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6897768","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":509207811,"identity":"bc09a25b-54e5-4491-bdad-4f35b71006af","order_by":0,"name":"W D J K 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Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Penile squamous cell carcinoma, Anal squamous cell carcinoma, HPV infection","lastPublishedDoi":"10.21203/rs.3.rs-6897768/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6897768/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eIntroduction\u003c/strong\u003e The Human Papilloma Virus (HPV) infection is known to cause anogenital cancers. Male HPV prevalence and population-attributable risk (PAR)are important to plan future HPV preventive strategies for HPV-driven anogenital cancers in males.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e A hospital-based case-control study was carried out to determine the etiologic fraction attributed to HPV-driven anal and penile(anogenital) cancers among male patients presenting to tertiary care hospitals in Gampaha district and Apeksha Hospital (cancer specialized), Sri Lanka and to calculate PAR percentage on anogenital SCC among the study population where HPV prevalence was 5.7%. New or already diagnosed patients for anal and penile SCC who reported to selected hospitals from August 2022 to June 2023 were recruited for data and specimen collection. A sample size of 20 cases and 80 controls were selected, with four controls chosen per case from sexually active, clinically normal men aged 20-70 years residing in the Gampaha district. Additional etiological factors that were checked included the presence of sexually transmitted infections, phimosis, anogenital injury, and the use of tobacco, alcohol or illegal drugs. The chi-square test was used at the level p\u0026lt;0.05 significance. Bivariable and logistic regression analyses were used to calculate odds ratios (ORs).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e A significantly associated factor for getting anal and penile SCC was HPV infection (p\u0026lt;0.001; adjusted OR: 27.7; 95% CI: 4.3,177.8).For any HPV genotype \u0026amp; high-risk HPV genotype, prevalence was 55% \u0026amp; 50% among cases and 5% \u0026amp; 2.5% among controls respectively. Assuming prevalence among controls as the population prevalence, the calculated PAR% was 62.2% for any HPV genotype and 33% for the HPV 16 HR genotype.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions\u003c/strong\u003e Sixty-two per cent of the anal and penile SCCs were attributed to any HPV genotype and one-third of anal and penile SCCs can be prevented by introducing HPV 16 genotype-containing vaccine to male.\u003c/p\u003e","manuscriptTitle":"Etiologic fraction of HPV-attributed anal and penile squamous cell carcinoma: study in specialized hospitals, Sri Lanka","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-09-05 04:40:10","doi":"10.21203/rs.3.rs-6897768/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-09-26T14:09:36+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-09-17T05:54:53+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-09-08T19:41:35+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"98376388720171784317108203172342456481","date":"2025-09-08T16:42:00+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"54882253741618941321763815389264559823","date":"2025-09-08T06:10:00+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-08-29T10:13:10+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-08-28T06:18:18+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-08-06T04:12:33+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-08-05T13:52:51+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Infectious Diseases","date":"2025-08-05T13:50:27+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-infectious-diseases","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"infd","sideBox":"Learn more about [BMC Infectious Diseases](http://bmcinfectdis.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/infd","title":"BMC Infectious Diseases","twitterHandle":"#bmcinfectdis","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"04f82511-4e22-434b-a3dd-8d0f2606b005","owner":[],"postedDate":"September 5th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-12-29T16:00:08+00:00","versionOfRecord":{"articleIdentity":"rs-6897768","link":"https://doi.org/10.1186/s12879-025-12449-2","journal":{"identity":"bmc-infectious-diseases","isVorOnly":false,"title":"BMC Infectious Diseases"},"publishedOn":"2025-12-27 15:57:30","publishedOnDateReadable":"December 27th, 2025"},"versionCreatedAt":"2025-09-05 04:40:10","video":"","vorDoi":"10.1186/s12879-025-12449-2","vorDoiUrl":"https://doi.org/10.1186/s12879-025-12449-2","workflowStages":[]},"version":"v1","identity":"rs-6897768","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6897768","identity":"rs-6897768","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}