Elements of an Anal Dysplasia Screening Program

Jay, Naomi

doi:10.1016/j.jana.2011.08.006

Cited by 24 publications

(26 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Multi-state Markov models have been used to understand the natural history of cervical neoplasia [14]–[17] as well as to model the cost-effectiveness of screening programs for anal cancer and its precursors [18]–[20]. A recent analysis of cervical cytology and human papilloma virus (HPV) DNA samples in a cohort of HIV-infected and high risk HIV-negative women used a 3-state cytology-based Markov model ([1] no SIL, [2] SIL, and [3] the absorbing state of treatment for SIL or invasive cervical cancer) to determine factors associated with transitions between cervical cytopathologic states [21]. In the latter study, SIL was defined, in the primary analysis, to include ASCUS, LSIL, and HSIL cytologic findings.…”

Section: Discussionmentioning

confidence: 99%

“…Anal cytology was obtained using a moistened Dacron swab and processed using conventional slide fixation between 2001–2006 and using SurePath liquid cytology media thereafter. HRA with biopsy was performed by trained clinicians using methods previously described [2]. Followup screening with cytology and DRE was recommended annually by clinic protocol for all patients.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Natural History of Anal Dysplasia in an HIV-Infected Clinical Care Cohort: Estimates Using Multi-State Markov Modeling

et al. 2014

View full text Add to dashboard Cite

Objectives(1) To model the natural history of anal neoplasia in HIV-infected patients using a 3-state Markov model of anal cancer pathogenesis, adjusting for cytology misclassification; and (2) to estimate the effects of selected time-varying covariates on transition probabilities.DesignA retrospective cytology-based inception screening cohort of HIV-infected adults was analyzed using a 3-state Markov model of clinical pathogenesis of anal neoplasia.MethodsLongitudinally ascertained cytology categories were adjusted for misclassification using estimates of cytology accuracy derived from the study cohort. Time-varying covariate effects were estimated as hazard ratios.Results(1) There was a moderate to high probability of regression of the high grade squamous intraepithelial lesion (HSIL) state (27–62%) at 2 years after initial cytology screening; (2) the probability of developing invasive anal cancer (IAC) during the first 2 years after a baseline HSIL cytology is low (1.9–2.8%); (3) infrared coagulation (IRC) ablation of HSIL lesions is associated with a 2.2–4.2 fold increased probability of regression to

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Natural History of Anal Dysplasia in an HIV-Infected Clinical Care Cohort: Estimates Using Multi-State Markov Modeling

et al. 2014

View full text Add to dashboard Cite

show abstract

“…Following informed consent, every participant underwent an endoanal sample using a FLOQswab put into SurePath fixative (Becton Dickinson & Co.). Sampling involved a FLOQswab premoistened with SurePath which was inserted beyond the internal sphincter to 2-3 in, which was then withdrawn using a circular motion to sample all sides of the anal canal [8]. Digital rectal examination was then performed using lubricant/lidocaine gel, followed by the insertion of a disposable anoscope (Pelican Feminine Healthcare, Cardiff, UK).…”

Section: Methodsmentioning

confidence: 99%

A prospective study of anal cancer screening in HIV-positive and negative MSM

Schofield

Sadler

Nelson

et al. 2016

Aids

View full text Add to dashboard Cite

The high prevalence of high-risk-HPV and frequency of false negative cytology in this study suggest that high-resolution anoscopy would have most clinical utility, as a primary screening tool for anal cancer in a high-risk group. The prevalence of AIN3+ in HIV-positive MSM lends support for a policy of screening this group, but the high prevalence of lower grade lesions which do not warrant immediate treatment and the limitations of treating high-grade lesions requires careful consideration in terms of a screening policy.

show abstract

“…Others have used cervical brushes [ 26 -28 ] and fl ocked nylon swabs [ 24 , 29 ]. The swab may be better tolerated by the patient than the cytobrush [ 22 ]. The type of device is probably less important than the skill of the operator in collecting an adequate sample [ 30 ].…”

Section: Samplingmentioning

confidence: 99%

Anal Cytology

Darragh

Palefsky

2015

The Bethesda System for Reporting Cervical Cytology

View full text Add to dashboard Cite

Anal cytology was fi rst included in the 2001 Bethesda System Atlas. It has gained acceptance as a tool for anal cancer screening in conjunction with high-resolution anoscopy (HRA) and biopsy -in a role similar to the Pap test [ 1 -4 ]. Recommendations in TBS 2001 included guidance on sampling, adequacy, use of Bethesda terminology for anal cytology, and basic morphologic characteristics of anal squamous intraepithelial lesions (ASIL). This 2014 update to the chapter incorporates a brief review of the epidemiology of anal cancer, additional images, and expands information on the performance characteristics of anal cytology, the role of HPV testing and biomarkers, and briefl y addresses clinical management. Anal CancerAnal squamous cell carcinoma is an uncommon cancer. Over 90 % of anal cancers are attributable to persistent HPV infections with HPV16 predominating [ 5 ]. The 2014 American Cancer Society [ 6 ] estimates for anal cancer in the United States are approximately 7,210 new cases (4,550 in women and 2,660 in men) and 950 deaths (580 in women and 370 in men). However, rates of anal squamous cell carcinoma have been increasing over the last several decades, especially in high-risk groups.

show abstract

Elements of an Anal Dysplasia Screening Program

Cited by 24 publications

References 38 publications

Natural History of Anal Dysplasia in an HIV-Infected Clinical Care Cohort: Estimates Using Multi-State Markov Modeling

Natural History of Anal Dysplasia in an HIV-Infected Clinical Care Cohort: Estimates Using Multi-State Markov Modeling

A prospective study of anal cancer screening in HIV-positive and negative MSM

Anal Cytology

Contact Info

Product

Resources

About