Prevalence of high-grade anal dysplasia among women with high-grade lower genital tract dysplasia or cancer: Results of a pilot study.
Adult
Age Factors
Aged
Anal Canal
/ diagnostic imaging
Cross-Sectional Studies
Endoscopy, Gastrointestinal
Female
Genital Neoplasms, Female
/ epidemiology
Genitalia, Female
/ pathology
Humans
Middle Aged
Papillomaviridae
/ isolation & purification
Papillomavirus Infections
/ diagnostic imaging
Pilot Projects
Prevalence
Risk Factors
Squamous Intraepithelial Lesions of the Cervix
/ epidemiology
Anal dysplasia
Anal screening
Cervical dysplasia or cancer
Prevalence
Vaginal dysplasia or cancer
Vulvar dysplasia or cancer
Journal
Gynecologic oncology
ISSN: 1095-6859
Titre abrégé: Gynecol Oncol
Pays: United States
ID NLM: 0365304
Informations de publication
Date de publication:
05 2019
05 2019
Historique:
received:
14
12
2018
revised:
20
02
2019
accepted:
23
02
2019
pubmed:
5
3
2019
medline:
6
7
2019
entrez:
5
3
2019
Statut:
ppublish
Résumé
To estimate the prevalence of high-grade anal dysplasia in women with high-grade dysplasia or carcinoma of the cervix, vagina or vulva. In this cross-sectional study, participants underwent anal cytology, anal HPV testing with Cervista HPV16/18 and high-resolution anoscopy (HRA). Patients with HSIL (high-grade squamous cell intraepithelial lesion) or greater on anal cytology or anal biopsy were referred to a colorectal surgery specialist for further evaluation. Seventy-five women were enrolled in the study, including 47 with cervical (cervix group), 10 with vaginal (vagina group), 15 with vulvar (vulva group), 1 with cervical and vaginal, and 2 with vulvar and vaginal disease. The median age in the cervix group (40 years (range 26-69)) was substantially younger than in the vagina (60 years (38-69)) and the vulva (59 years (36-75)) groups. Anal HSIL based on composite endpoints of the most severe cytology or histology result was diagnosed in 6 patients (8.0%). Anal cytology revealed HSIL in 2 (2.7%), atypical squamous cells of undetermined significance (ASCUS) in 12 (16.0%), low-grade squamous cell intraepithelial lesion (LSIL) in 2 (2.7%), and was normal in 59 (78.7%) patients. Anal HPV16/18 test was positive in 15 (20.0%), negative in 48 (64.0%) and insufficient in 12 (16.0%) patients. Of the 6 women with high-grade anal dysplasia, three (50%) had a positive anal HPV16/18 test. No case of anal cancer was observed. Our results suggest that the prevalence of anal HSIL is elevated among women with HPV-related lower genital tract dysplasia or cancer. To further support the inclusion of this high-risk group into screening guidelines for anal dysplasia, further studies are necessary to determine what screening strategy is suited to this population.
Identifiants
pubmed: 30827725
pii: S0090-8258(19)30134-9
doi: 10.1016/j.ygyno.2019.02.024
pmc: PMC7104617
mid: NIHMS1575969
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
266-270Subventions
Organisme : NCI NIH HHS
ID : P30 CA016672
Pays : United States
Informations de copyright
Copyright © 2019 Elsevier Inc. All rights reserved.
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