We compared the pathological diagnoses obtained by anal Papanicolaou (Pap) smear with those obtained by anal biopsy or by surgical excision for 153 men who have sex with men (MSM). Analysis of these paired specimens showed that anal Pap smears were an inaccurate predictor of high-grade anal dysplasia, regardless of human immunodeficiency virus (HIV) serostatus. The presence of any abnormal anal cytological finding indicates a potential for high-grade dysplasia on histological examination of MSM.

4.

Human papillomavirus causes anal condylomata, high-grade intraepithelial neoplasia (HGAIN), and squamous cell cancer (SCCA). We found HGAIN or SCCA in 75/159 (47%) HIV-seropositive and 42/160 (26%) HIV-seronegative men who have sex with men (MSM) with anal condylomata meriting surgery (p<0.0001, chi-square). Anal condylomata in MSM often harbor HGAIN and SCCA.

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