{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T17:48:08Z","timestamp":1778694488218,"version":"3.51.4"},"reference-count":70,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T00:00:00Z","timestamp":1696291200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Human Papillomavirus (HPV) is the primary risk factor for the development of anal intraepithelial neoplasia (AIN) and is a leading risk factor for anogenital squamous cell carcinoma (ASCC). Despite common shared risk factors for both HPV and syphilis, co-infection is not well documented, and the role of syphilitic infection in HPV-associated AIN and ASCC potentiation is not defined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case description\/methods<\/jats:title><jats:p>A 72-year-old single male presented with complaints of mild rectal pain and intermittent rectal bleeding. A flexible sigmoidoscopy was performed, and a firm 4.5cm x 3cm perianal mass was detected and superficially biopsied. Pathology findings demonstrated evidence of a high grade squamous intraepithelial lesion (HGSIL, AIN II\/III\/AIS) with viral cytopathic effect, consistent with HPV infection. Much of the biopsied lesion showed acanthotic squamous mucosa with intraepithelial neutrophils and abundant submucosal plasma cells, suggesting possible syphilitic involvement. Subsequent immunohistochemical staining for p16 as a surrogate marker for HPV was positive, as was an immunohistochemical stain for spirochetes, supportive of co-infection with <jats:italic>Treponema pallidum pallidum<\/jats:italic> (<jats:italic>T. pallidum)<\/jats:italic>, the causative agent in venereal syphilis. The patient was referred to an infectious disease specialist for syphilitic infection and was treated with penicillin with surprisingly complete resolution of the lesion. EUAs were performed 2- and 3-months following treatment without lesion recurrence. However, one year following diagnosis, a flexible sigmoidoscopy revealed a 5\u00a0mm recurrent HPV-related low-grade AIN 1 lesion at the dentate line.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Resolution of the lesion by antibiotic treatment for syphilitic infection suggested that co-infection by <jats:italic>T. pallidum<\/jats:italic> may potentiate HPV-associated squamous cell carcinoma based on histological findings. Findings from this case, as well as a review of bacterial involvement and potentiation in various cancers, are reviewed here. Such findings offer new insight regarding the role of STI-associated bacteria and HPV co-infection in the establishment of AIN and may additionally propose new treatment modalities for ASCC.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fonc.2023.1226202","type":"journal-article","created":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T10:32:23Z","timestamp":1696329143000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Case Report: Resolution of high grade anal squamous intraepithelial lesion with antibiotics proposes a new role for syphilitic infection in potentiation of HPV-associated ASCC"],"prefix":"10.3389","volume":"13","author":[{"given":"A.","family":"Ranabhotu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N.","family":"Habibian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B.","family":"Patel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Farrell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Do","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Sedghi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.","family":"Sedghi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,10,3]]},"reference":[{"key":"B1","unstructured":"What Is Anal Cancer? | Types of Anal Cancer"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyw276","article-title":"International trends in anal cancer incidence rates","volume":"46","author":"Islami","year":"2017","journal-title":"Int J Epidemiol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1111\/codi.12553","article-title":"The rising incidence of anal cancer in England 1990-2010: a population-based study","volume":"16","author":"Wilkinson","year":"2014","journal-title":"Colorectal Dis Off J Assoc Coloproctol G. B Irel"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2021.06.015","article-title":"Anal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up\u2606","volume":"32","author":"Rao","year":"2021","journal-title":"Ann Oncol Off J Eur Soc Med Oncol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/j.currproblcancer.2018.11.001","article-title":"Squamous cell carcinoma of the anal canal","volume":"42","author":"Morton","year":"2018","journal-title":"Curr Probl Cancer"},{"key":"B6","volume-title":"Anal Cancer - Statistics","author":"Henry","year":"2012"},{"key":"B7","unstructured":"Cancer Facts & Figures\u00a02018"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(17)30456-4","article-title":"Nodal stage migration and prognosis in anal cancer: a systematic review, meta-regression, and simulation study","volume":"18","author":"Sekhar","year":"2017","journal-title":"Lancet Oncol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"198","DOI":"10.1016\/S1473-3099(17)30653-9","article-title":"Human papillomavirus types from infection to cancer in the anus, according to sex and HIV status: a systematic review and meta-analysis","volume":"18","author":"Lin","year":"2018","journal-title":"Lancet Infect Dis"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.20365","article-title":"Human papillomavirus, smoking, and sexual practices in the etiology of anal cancer","volume":"101","author":"Daling","year":"2004","journal-title":"Cancer"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.30716","article-title":"Worldwide burden of cancer attributable to HPV by site, country and HPV type","volume":"141","author":"de Martel","year":"2017","journal-title":"Int J Cancer"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1097\/00126334-200412150-00004","article-title":"HIV-associated anal cancer: has highly active antiretroviral therapy reduced the incidence or improved the outcome","volume":"37","author":"Bower","year":"2004","journal-title":"J Acquir Immune Defic Syndr 1999"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(07)70043-8","article-title":"Risk of anogenital cancer after diagnosis of cervical intraepithelial neoplasia: a prospective population-based study","volume":"8","author":"Edgren","year":"2007","journal-title":"Lancet Oncol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(96)03409-5","article-title":"Epidermoid anal cancer: results from the UKCCCR randomised trial of radiotherapy alone versus radiotherapy, 5-fluorouracil, and mitomycin. UKCCCR Anal Cancer Trial Working Party. UK Co-ordinating Committee on Cancer Research","volume":"348","year":"1996","journal-title":"Lancet Lond Engl"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1996.14.9.2527","article-title":"Role of mitomycin in combination with fluorouracil and radiotherapy, and of salvage chemoradiation in the definitive nonsurgical treatment of epidermoid carcinoma of the anal canal: results of a phase III randomized intergroup study","volume":"14","author":"Flam","year":"1996","journal-title":"J Clin Oncol Off J Am Soc Clin Oncol"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1997.15.5.2040","article-title":"Concomitant radiotherapy and chemotherapy is superior to radiotherapy alone in the treatment of locally advanced anal cancer: results of a phase III randomized trial of the European Organization for Research and Treatment of Cancer Radiotherapy and Gastrointestinal Cooperative Groups","volume":"15","author":"Bartelink","year":"1997","journal-title":"J Clin Oncol Off J Am Soc Clin Oncol"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1053\/ctrv.2000.0175","article-title":"Long-term chemotherapy-related cardiovascular morbidity","volume":"26","author":"Meinardi","year":"2000","journal-title":"Cancer Treat Rev"},{"key":"B18","unstructured":"Chemotherapy Side Effects"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v21.i8.2294","article-title":"Anal cancer treatment: current status and future perspectives","volume":"21","author":"Ghosn","year":"2015","journal-title":"World J Gastroenterol"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v20.i36.13052","article-title":"Anal squamous cell carcinoma: an evolution in disease and management","volume":"20","author":"Osborne","year":"2014","journal-title":"World J Gastroenterol"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1200\/OP.20.00122","article-title":"Patient-reported GI outcomes in patients with anal cancer receiving modern chemoradiation","volume":"16","author":"Kouzy","year":"2020","journal-title":"JCO Oncol Pract"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(07)70202-4","article-title":"Non-operative treatment after neoadjuvant chemoradiotherapy for rectal cancer","volume":"8","author":"O\u2019Neill","year":"2007","journal-title":"Lancet Oncol"},{"key":"B23","doi-asserted-by":"publisher","first-page":"50","DOI":"10.4251\/wjgo.v9.i2.50","article-title":"Anal intraepithelial neoplasia: A review of diagnosis and management","volume":"9","author":"Roberts","year":"2017","journal-title":"World J Gastrointest Oncol"},{"key":"B24","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1055\/s-0035-1570394","article-title":"Screening, surveillance, and treatment of anal intraepithelial neoplasia","volume":"29","author":"Long","year":"2016","journal-title":"Clin Colon Rectal Surg"},{"key":"B25","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1016\/j.ijscr.2015.10.035","article-title":"A case of syphilitic anal condylomata lata mimicking Malignancy","volume":"17","author":"Tayal","year":"2015","journal-title":"Int J Surg Case Rep"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1016\/j.pvr.2017.10.004","article-title":"Syndemic synergy of HPV and other sexually transmitted pathogens in the development of high-grade anal squamous intraepithelial lesions","volume":"4","author":"McCloskey","year":"2017","journal-title":"Papillomavirus Res Amst Neth"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1590\/S1413-86702009000300010","article-title":"A syphilis co-infection study in human papilloma virus patients attended in the sexually transmitted infection ambulatory clinic, Santa Casa de Miseric\u00f3rdia Hospital, Rio de Janeiro, Brazil","volume":"13","author":"de Sena Souza","year":"2009","journal-title":"Braz J Infect Dis Off Publ Braz Soc Infect Dis"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.28979","article-title":"Human papillomavirus DNA load and p16INK4a expression predict for local control in patients with anal squamous cell carcinoma treated with chemoradiotherapy","volume":"136","author":"R\u00f6del","year":"2015","journal-title":"Int J Cancer"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0108790","article-title":"The prognostic value of HPV status and p16 expression in patients with carcinoma of the anal canal","volume":"9","author":"Urgoiti","year":"2014","journal-title":"PloS One"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1097\/01.MP.0000077417.08371.CE","article-title":"Expression of p16, Rb, and p53 proteins in squamous cell carcinomas of the anorectal region harboring human papillomavirus DNA","volume":"16","author":"Lu","year":"2003","journal-title":"Mod Pathol Off J U S Can Acad Pathol Inc"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1038\/nrmicro1130","article-title":"Opinion: Bacterial toxins and cancer\u2013a case to answer","volume":"3","author":"Lax","year":"2005","journal-title":"Nat Rev Microbiol"},{"key":"B32","article-title":"Increased oxidative DNA damage in Helicobacter pylori-infected human gastric mucosa","volume":"56","author":"Baik","year":"1996","journal-title":"Cancer Res"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0119471","article-title":"The quorum sensing peptides PhrG, CSP and EDF promote angiogenesis and invasion of breast cancer cells in vitro","volume":"10","author":"De Spiegeleer","year":"2015","journal-title":"PloS One"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19901215)66:12<2569::AID-CNCR2820661220>3.0.CO;2-I","article-title":"Helicobacter pylori and gastric carcinoma. Serum antibody prevalence in populations with contrasting cancer risks","volume":"66","author":"Correa","year":"1990","journal-title":"Cancer"},{"key":"B35","doi-asserted-by":"publisher","first-page":"799","DOI":"10.1016\/j.dld.2012.03.020","article-title":"Immunoproliferative small intestinal disease associated with Campylobacter jejuni","volume":"44","author":"Mesnard","year":"2012","journal-title":"Dig Liver Dis Off J Ital Soc Gastroenterol Ital Assoc Study Liver"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1097\/00008469-199504000-00010","article-title":"The association between typhoid carriage, typhoid infection and subsequent cancer at a number of sites","volume":"4","author":"Caygill","year":"1995","journal-title":"Eur J Cancer Prev Off J Eur Cancer Prev Organ ECP"},{"key":"B37","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1016\/j.cellimm.2015.11.007","article-title":"Mycobacterium tuberculosis H37Rv infected THP-1 cells induce epithelial mesenchymal transition (EMT) in lung adenocarcinoma epithelial cell line (A549)","volume":"300","author":"Gupta","year":"2016","journal-title":"Cell Immunol"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djh102","article-title":"Evidence for an association between Chlamydia psittaci and ocular adnexal lymphomas","volume":"96","author":"Ferreri","year":"2004","journal-title":"J Natl Cancer Inst"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.2.1563.1356","article-title":"An address on a characteristic organism of cancer","volume":"2","author":"Russell","year":"1890","journal-title":"Br Med J"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-193101000-00023","article-title":"Studies in hodgkin\u2019s disease","volume":"93","author":"L\u2019esperance","year":"1931","journal-title":"Ann Surg"},{"key":"B41","article-title":"Tumor incidence in ICR\/albino and C57\/B16JNIcr male mice injected with organisms cultured from mouse Malignant tissue","volume":"38","author":"Diller","year":"1974","journal-title":"Growth"},{"key":"B42","doi-asserted-by":"publisher","first-page":"30751","DOI":"10.1038\/srep30751","article-title":"The microbiome of aseptically collected human breast tissue in benign and Malignant disease","volume":"6","author":"Hieken","year":"2016","journal-title":"Sci Rep"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1126\/science.aay9189","article-title":"The human tumor microbiome is composed of tumor type-specific intracellular bacteria","volume":"368","author":"Nejman","year":"2020","journal-title":"Science"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-020-2095-1","article-title":"Microbiome analyses of blood and tissues suggest cancer diagnostic approach","volume":"579","author":"Poore","year":"2020","journal-title":"Nature"},{"key":"B45","doi-asserted-by":"publisher","first-page":"8061","DOI":"10.3390\/ijms21218061","article-title":"The role of the microbiome in oral squamous cell carcinoma with insight into the microbiome-treatment axis","volume":"21","author":"Sami","year":"2020","journal-title":"Int J Mol Sci"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.4209","article-title":"Periodontal pathogens Porphyromonas gingivalis and Fusobacterium nucleatum promote tumor progression in an oral-specific chemical carcinogenesis model","volume":"6","author":"Binder Gallimidi","year":"2015","journal-title":"Oncotarget"},{"key":"B47","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1186\/s13027-019-0239-4","article-title":"The potential role of P.gingivalis in gastrointestinal cancer: a mini review","volume":"14","author":"Liu","year":"2019","journal-title":"Infect Agent Cancer"},{"key":"B48","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1101\/gr.126516.111","article-title":"Fusobacterium nucleatum infection is prevalent in human colorectal carcinoma","volume":"22","author":"Castellarin","year":"2012","journal-title":"Genome Res"},{"key":"B49","doi-asserted-by":"publisher","first-page":"4146","DOI":"10.3390\/ijms20174146","article-title":"Oral bacteria and intestinal dysbiosis in colorectal cancer","volume":"20","author":"Koliarakis","year":"2019","journal-title":"Int J Mol Sci"},{"key":"B50","doi-asserted-by":"publisher","DOI":"10.2147\/JIR.S344321","article-title":"Oral-intestinal microbiota in colorectal cancer: inflammation and immunosuppression","volume":"15","author":"Mo","year":"2022","journal-title":"J Inflamm Res"},{"key":"B51","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2017-314814","article-title":"The oral microbiota in colorectal cancer is distinctive and predictive","volume":"67","author":"Flemer","year":"2018","journal-title":"Gut"},{"key":"B52","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.22325","article-title":"Risk of cervical cancer associated with Chlamydia trachomatis antibodies by histology, HPV type and HPV cofactors","volume":"120","author":"Madeleine","year":"2007","journal-title":"Int J Cancer"},{"key":"B53","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0215(20000101)85:1<35::AID-IJC6>3.0.CO;2-A","article-title":"Chlamydia trachomatis infection as a risk factor for invasive cervical cancer","volume":"85","author":"Koskela","year":"2000","journal-title":"Int J Cancer"},{"key":"B54","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1001\/jama.285.1.47","article-title":"Serotypes of Chlamydia trachomatis and risk for development of cervical squamous cell carcinoma","volume":"285","author":"Anttila","year":"2001","journal-title":"JAMA"},{"key":"B55","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2015.12.017","article-title":"Head and neck squamous cell carcinoma: update on epidemiology, diagnosis, and treatment","volume":"91","author":"Marur","year":"2016","journal-title":"Mayo Clin Proc"},{"key":"B56","doi-asserted-by":"publisher","DOI":"10.4236\/jct.2012.34037","article-title":"Oral squamous cell carcinoma: epidemiology, clinical presentation and treatment","volume":"3","author":"Feller","year":"2012","journal-title":"J Cancer Ther"},{"key":"B57","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1016\/j.oraloncology.2004.08.011","article-title":"Multivariate analysis of risk factors for wound infection in head and neck squamous cell carcinoma surgery with opening of mucosa. Study of 260 surgical procedures","volume":"41","author":"Penel","year":"2005","journal-title":"Oral Oncol"},{"key":"B58","doi-asserted-by":"publisher","first-page":"CD007107","DOI":"10.1002\/14651858.CD007107.pub2","article-title":"Prophylactic antibiotics or G-CSF for the prevention of infections and improvement of survival in cancer patients undergoing chemotherapy","volume":"1","author":"Herbst","year":"2009","journal-title":"Cochrane Database Syst Rev"},{"key":"B59","doi-asserted-by":"publisher","first-page":"958","DOI":"10.1053\/j.gastro.2019.10.020","article-title":"Western diet promotes intestinal colonization by collagenolytic microbes and promotes tumor formation after colorectal surgery","volume":"158","author":"Gaines","year":"2020","journal-title":"Gastroenterology"},{"key":"B60","doi-asserted-by":"publisher","first-page":"286ra68","DOI":"10.1126\/scitranslmed.3010658","article-title":"Collagen degradation and MMP9 activation by Enterococcus faecalis contribute to intestinal anastomotic leak","volume":"7","author":"Shogan","year":"2015","journal-title":"Sci Transl Med"},{"key":"B61","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1186\/2049-2618-2-35","article-title":"Intestinal anastomotic injury alters spatially defined microbiome composition and function","volume":"2","author":"Shogan","year":"2014","journal-title":"Microbiome"},{"key":"B62","doi-asserted-by":"publisher","first-page":"103566","DOI":"10.1016\/j.ijnurstu.2020.103566","article-title":"Barriers to older adults seeking sexual health advice and treatment: A scoping review","volume":"107","author":"Ezhova","year":"2020","journal-title":"Int J Nurs Stud"},{"key":"B63","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-21-1346","article-title":"Possible reactivation of latent anal human papillomavirus associated with markers of immune dysfunction in gay and bisexual men","volume":"31","author":"Poynten","year":"2022","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"key":"B64","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2021.781759","article-title":"New syphilis cases in older adults, 2004-2019: an analysis of surveillance data from south China","volume":"8","author":"Wang","year":"2021","journal-title":"Front Med"},{"key":"B65","doi-asserted-by":"publisher","first-page":"2462","DOI":"10.3390\/ijerph17072462","article-title":"Sexually transmitted infection knowledge among older adults: psychometrics and test-retest reliability","volume":"17","author":"Smith","year":"2020","journal-title":"Int J Environ Res Public Health"},{"key":"B66","doi-asserted-by":"publisher","DOI":"10.1177\/0956462419886772","article-title":"Risk factors predictive of sexually transmitted infection diagnosis in young compared to older patients attending sexually transmitted diseases clinics","volume":"31","author":"Tao","year":"2020","journal-title":"Int J STD AIDS"},{"key":"B67","doi-asserted-by":"publisher","DOI":"10.4103\/ijstd.IJSTD_60_20","article-title":"Sexually transmitted infections in the elderly: A 6-year retrospective study in a tertiary care hospital in New Delhi","volume":"42","author":"Relhan","year":"2021","journal-title":"Indian J Sex Transm Dis AIDS"},{"key":"B68","doi-asserted-by":"publisher","first-page":"1","DOI":"10.7326\/0003-4819-153-1-201007060-00003","article-title":"Sexually transmitted diseases among users of erectile dysfunction drugs: analysis of claims data","volume":"153","author":"Jena","year":"2010","journal-title":"Ann Intern Med"},{"key":"B69","unstructured":"AtlasPlus - Charts"},{"key":"B70","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-145-6-200609190-00005","article-title":"Discordance between sexual behavior and self-reported sexual identity: a population-based survey of New York City men","volume":"145","author":"Pathela","year":"2006","journal-title":"Ann Intern Med"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2023.1226202\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T10:32:39Z","timestamp":1696329159000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2023.1226202\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,3]]},"references-count":70,"alternative-id":["10.3389\/fonc.2023.1226202"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2023.1226202","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,3]]},"article-number":"1226202"}}