Importance of anal cytology and screening for anal dysplasia in individuals living with HIV with an emphasis on women

Cimic, Adela; Wilkin, Timothy; Heymann, Jonas J.; Alperstein, Susan; Ellsworth, Grant; Siddiqui, Momin T.

doi:10.1002/cncy.22151

Cited by 12 publications

(12 citation statements)

References 19 publications

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“…Our findings are similar to those observed among HIV‐positive women followed for 10 years. This research observed that ASC on anal cytology had a high risk of anal squamous intraepithelial lesion 22 . Although atypical anal cytology is low in the general population, it seems interesting to offer anal screening for risk groups.…”

Section: Discussionmentioning

confidence: 73%

Liquid‐based cytology and HPV DNA test in anal specimens from women with cervical cancer

Eleutério

Surimã

Lima

et al. 2021

Diagnostic Cytopathology

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Introduction Cervical and anus cancers have similarities: association with HPV infection, epithelial transformation zone, and precursor lesions. However, it is still unclear whether women with cervical cancer should be screened to identify high‐grade squamous intraepithelial lesions and anal cancer. We aimed to identify high‐risk HPV and cytological atypia in anal samples from women diagnosed with invasive squamous cell carcinoma of the cervix. Study design We conducted a cross‐sectional study between July 2016 and August 2017 in reference services in oncology in the State of Ceará, Brazil. We studied 59 patients diagnosed with frankly invasive squamous cell carcinoma of the cervix (at least stages IB) and 60 women in a control group. We performed liquid‐based cytology (Surepath™) and HPV test (Cobas® 4800 System Test) of anal samples. To determine statistical significance with a confidence interval of 95%, we used Fisher's exact test and Student's t‐test using the GraphPad Prism 7.0 software. Results The mean age in the control group was 56.7 ± 8.5 years, while in the group of women with cervical squamous cancer, it was 54.3 ± 14.8. The liquid‐based cytology results of the satisfactory cases were: negative for intraepithelial lesion or malignancy (NLM): 51 cases (85%) in the control group and 38 (64.4%) in the study group (p = .0116). The HPV test was negative more frequently in the control group (n = 56, 93.3%) than in the study group (n = 17, 31.5%) (p < .0001). HPV 16 was the most frequent type (67.6%). Conclusions There is a higher frequency of high‐risk HPV and atypical cytology in women with cervical cancer than without lesions. Thus, this group should be considered as a target population for screening.

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Section: Discussionmentioning

confidence: 73%

Liquid‐based cytology and HPV DNA test in anal specimens from women with cervical cancer

Eleutério

Surimã

Lima

et al. 2021

Diagnostic Cytopathology

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“…Collection of the anal specimens presents more difficulties than cervical samples, since it is performed blindly and with a larger mucosal surface. These issues can hinder obtaining a sample that represents the entire area subject to disease and can lead to lower diagnostic performance when compared to cervical cytology 16 . The same difficulties point to diagnostic limitations in HRA 17 besides the rugosity of the anal mucosa.…”

Section: Discussionmentioning

confidence: 99%

Conventional cytologic diagnosis of human papillomavirus‐induced anal intraepithelial neoplasia: The experience of a referral center in Rio de Janeiro, Brazil

Barcellos

Coutinho

Cytryn

et al. 2022

Diagnostic Cytopathology

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Background Screening of anal cancer is rarely available or performed in Brazil. This study analyzes the diagnostic performance of conventional cytology (CC) in the prevention of anal cancer in a coloproctology and gynecology outpatient clinics in a public hospital in Rio de Janeiro, Brazil. Methods From 2005 to 2017, 1066 conventional cytological samples were collected. We analyze the causes of unsatisfactory samples (11.3%) and compare the cytological diagnoses of 83 samples from persons living with HIV and persons not living with HIV and in specific situations, using as the gold standard high‐resolution anoscopy or histopathology in cases biopsied within 6 months after cytology. Results The sensitivity of cytology with diagnosis of ASC‐US for detection of anal intraepithelial neoplasia of any grade was 85%, specificity was 41%, positive and negative predictive values were 64% and 75%, respectively, and positive and negative likelihood ratios were 1.46 and 0.35, respectively. Conclusion Conventional cytology available in resource‐limited settings is a simple, noninvasive, low‐cost method that proved feasible for outpatient screening of precursor lesions of the anal canal.

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“…Women with anal dysplasia almost always have a history of RAI and are likely to have concomitant cervical HPV localization and dysplasia. [ 39 40 ] High-grade cytology was found only in HIV-positive cases. Wu et al .…”

Section: Discussionmentioning

confidence: 99%

Transgenders are the most vulnerable amongst individuals engaging in receptive anal intercourse

Wadhwa

Arora

Pandhi

et al. 2021

Journal of Family Medicine and Primary Care

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Background: In India, sexuality not confirming to hetero-conjugal and peno-vaginal norm is abhorred and discriminated against. Individuals engaging in Receptive Anal Intercourse (RAI) are marginalized. Reappraisal of their sexual health conditions is likely to promote inclusive health care. Methods: Eighty-five consenting adults with RAI history were recruited from a tertiary care hospital in Delhi. Clinico-demographic data was noted and anal cytology samples were reported by Bethesda 2014 terminology. Results: There were 29 transgenders (TGs), 51 males (31 bisexual) and five females. Fifty-four subjects were Human Immunodeficiency Virus (HIV) infected (22 TGs, 31 males (17 bisexual) and one female) and 52 were receiving anti-retroviral treatment (ART). Thirty-one subjects had anal warts (6 TGs, 20 males, five females). Anal cytology revealed squamous intra-epithelial lesions (SIL) in 20 (5 TGs, 13 males, two females). TGs had significantly risker sexual practices than homosexual males, bisexual males and females, with consistently earlier age of first RAI exposure and frequent childhood (≤16 years) RAI experience compared to homosexual males, bisexual males and females, even after stratification by HIV status, warts and SIL. Conclusions: TGs had the highest sexual health risk profile including higher frequency of HIV infection compared to other subjects with RAI history. Bisexuality was common; their risk profile was variably lower than homosexual males. Mindfulness of above is likely to help overcome barriers to health care access and promote compassionate approach at all levels including primary care physicians.

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Importance of anal cytology and screening for anal dysplasia in individuals living with HIV with an emphasis on women

Cited by 12 publications

References 19 publications

Liquid‐based cytology and HPV DNA test in anal specimens from women with cervical cancer

Liquid‐based cytology and HPV DNA test in anal specimens from women with cervical cancer

Conventional cytologic diagnosis of human papillomavirus‐induced anal intraepithelial neoplasia: The experience of a referral center in Rio de Janeiro, Brazil

Transgenders are the most vulnerable amongst individuals engaging in receptive anal intercourse

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