Importance of anal cytology and screening for anal dysplasia in individuals living with HIV with an emphasis on women.
Anal Canal
/ cytology
Anus Neoplasms
/ diagnosis
Atypical Squamous Cells of the Cervix
/ pathology
Consensus
Digital Rectal Examination
Female
Follow-Up Studies
HIV Infections
/ complications
Humans
Male
Mass Screening
/ standards
Middle Aged
Papanicolaou Test
/ standards
Papillomaviridae
/ immunology
Papillomavirus Infections
/ diagnosis
Practice Guidelines as Topic
Precancerous Conditions
/ diagnosis
Proctoscopy
/ standards
Retrospective Studies
Sex Factors
CD4 count
HIV
anal Papanicolaou test
atypical squamous cells of undetermined significance (ASCUS)
human papillomavirus (HPV) in women
immunosuppression
Journal
Cancer cytopathology
ISSN: 1934-6638
Titre abrégé: Cancer Cytopathol
Pays: United States
ID NLM: 101499453
Informations de publication
Date de publication:
06 2019
06 2019
Historique:
received:
28
03
2019
accepted:
26
04
2019
pubmed:
31
5
2019
medline:
10
7
2020
entrez:
31
5
2019
Statut:
ppublish
Résumé
The incidence of squamous cell carcinoma of the anal canal has been increasing in high-risk populations. To the authors' knowledge, there is no international consensus regarding screening for squamous cell carcinoma of the anal canal, but screening is commonly comprised of a Papanicolaou (Pap) test in combination with digital anorectal examination followed by high-resolution anoscopy if necessary. The current study focused on individuals living with HIV and particularly on women living with HIV. In this 5-year retrospective study, the authors identified 5982 Pap tests, 1848 of which had follow-up biopsy within 6 months. The rate of atypical squamous cells of undetermined significance was 42%, and approximately 38.1% of cases with this interpretation were diagnosed as high-grade squamous intraepithelial lesions on follow-up biopsy. In addition, 82 women with anal cytology had long-term follow-up (>10 years) available. The authors investigated a relationship between cervicovaginal human papillomavirus (HPV) results, cervical pathology, CD4 T-cell count, and CD4/8 ratio with the anal cytology interpretation. A statistical correlation was noted between the CD4 count and the CD4/8 ratio and the presence of anal dysplasia. Nearly one-half of the women without cervicovaginal HPV positivity presented with anal dysplasia. The results of the current study demonstrated that, among women living with HIV, screening for anal dysplasia should not be eschewed, regardless of lower genital tract pathology and/or HPV status. To the authors' knowledge, the current study is the largest reported retrospective anal cytology cohort in individuals living with HIV.
Sections du résumé
BACKGROUND
The incidence of squamous cell carcinoma of the anal canal has been increasing in high-risk populations. To the authors' knowledge, there is no international consensus regarding screening for squamous cell carcinoma of the anal canal, but screening is commonly comprised of a Papanicolaou (Pap) test in combination with digital anorectal examination followed by high-resolution anoscopy if necessary. The current study focused on individuals living with HIV and particularly on women living with HIV.
METHODS
In this 5-year retrospective study, the authors identified 5982 Pap tests, 1848 of which had follow-up biopsy within 6 months. The rate of atypical squamous cells of undetermined significance was 42%, and approximately 38.1% of cases with this interpretation were diagnosed as high-grade squamous intraepithelial lesions on follow-up biopsy. In addition, 82 women with anal cytology had long-term follow-up (>10 years) available.
RESULTS
The authors investigated a relationship between cervicovaginal human papillomavirus (HPV) results, cervical pathology, CD4 T-cell count, and CD4/8 ratio with the anal cytology interpretation. A statistical correlation was noted between the CD4 count and the CD4/8 ratio and the presence of anal dysplasia. Nearly one-half of the women without cervicovaginal HPV positivity presented with anal dysplasia.
CONCLUSIONS
The results of the current study demonstrated that, among women living with HIV, screening for anal dysplasia should not be eschewed, regardless of lower genital tract pathology and/or HPV status. To the authors' knowledge, the current study is the largest reported retrospective anal cytology cohort in individuals living with HIV.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
407-413Informations de copyright
© 2019 American Cancer Society.
Références
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