Interobserver agreement in the interpretation of anal intraepithelial neoplasia

Lytwyn, Alice; Salit, Irving E.; Raboud, Janet; Chapman, William; Darragh, Teresa M.; Winkler, Barbara; Tinmouth, Jill; Mahony, James B.; Sano, Bun

doi:10.1002/cncr.20927

Cited by 113 publications

(90 citation statements)

References 33 publications

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“…As expected, classification agreement with lower variability between observers can be improved in a 2-tiered versus a 3-tiered system [10,28,[78][79][80][81][82][83][84][85][86][87]. Improved agreement among pathologists leads to a more consistent and reproducible diagnosis, which may lead to more valid clinical outcome data.…”

Section: Wg2 Recommendation Nomentioning

confidence: 81%

The Lower Anogenital Squamous Terminology Standardization Project for HPV-Associated Lesions: Background and Consensus Recommendations from the College of American Pathologists and the American Society for Colposcopy and Cervical Pathology

Darragh

Colgan

Cox

et al. 2012

Archives of Pathology &Amp; Laboratory Medicine

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641

372

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The terminology for human papillomavirus (HPV)–associated squamous lesions of the lower anogenital tract has a long history marked by disparate diagnostic terms derived from multiple specialties. It often does not reflect current knowledge of HPV biology and pathogenesis. A consensus process was convened to recommend terminology unified across lower anogenital sites. The goal was to create a histopathologic nomenclature system that reflects current knowledge of HPV biology, optimally uses available biomarkers, and facilitates clear communication across different medical specialties. The Lower Anogenital Squamous Terminology (LAST) Project was cosponsored by the College of American Pathologists and the American Society for Colposcopy and Cervical Pathology and included 5 working groups; 3 work groups performed comprehensive literature reviews and developed draft recommendations. Another work group provided the historical background and the fifth will continue to foster implementation of the LAST recommendations. After an open comment period, the draft recommendations were presented at a consensus conference attended by LAST work group members, advisors, and representatives from 35 stakeholder organizations including professional societies and government agencies. Recommendations were finalized and voted on at the consensus meeting. The final, approved recommendations standardize biologically relevant histopathologic terminology for HPV-associated squamous intraepithelial lesions and superficially invasive squamous carcinomas across all lower anogenital tract sites and detail the appropriate use of specific biomarkers to clarify histologic interpretations and enhance diagnostic accuracy. A plan for disseminating and monitoring recommendation implementation in the practicing community was also developed. The implemented recommendations will facilitate communication between pathologists and their clinical colleagues and improve accuracy of histologic diagnosis with the ultimate goal of providing optimal patient care.

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Section: Wg2 Recommendation Nomentioning

confidence: 81%

The Lower Anogenital Squamous Terminology Standardization Project for HPV-Associated Lesions: Background and Consensus Recommendations from the College of American Pathologists and the American Society for Colposcopy and Cervical Pathology

Darragh

Colgan

Cox

et al. 2012

Archives of Pathology &Amp; Laboratory Medicine

Self Cite

641

372

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“…58 As with cervical biopsies, the diagnosis of the atypical and immature transformation zone can be challenging. On histopathology, p16 INK4a (mtm Laboratories, Heidelberg, Germany) immunostaining improves interobserver agreement 59,60 ; and its role in anal cytopathology is under investigation.…”

Section: Histology Of Ain and Anal Cancermentioning

confidence: 99%

Anal cancer and cervical cancer screening: Key differences

Darragh

Winkler

2010

Cancer Cytopathology

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203

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Cervical cancer and anal cancer share many similarities including causation by oncogenic human papillomaviruses; however, significant differences exist in their epidemiology, risk factors, biologic behavior, management, and treatment. Although rare, the incidence of anal cancer is alarmingly high and continues to increase in high-risk populations, particularly men who have sex with men regardless of their human immunodeficiency virus (HIV) status. There are no national screening guidelines for anal cancer. Using the success of cervical cancer screening as a model, anal cancer screening approaches apply anal cytology, highresolution anoscopy, and directed biopsy to guide treatment and management strategies. Although much has been learned about the natural history and epidemiology of anal intraepithelial neoplasia (AIN), the rate of progression of high-grade anal intraepithelial neoplasia (HGAIN) to invasive squamous cell carcinomas is not known. The impact of screening and treatment of HGAIN on morbidity and mortality from anal cancer are also unknown. Because the incidence of HGAIN and anal squamous cell carcinoma continue to increase, it is imperative to find pathways for effective screening, early detection, and therapeutic intervention. This article provides an overview of anal cancer screening while highlighting its differences from cervi- Compared with cervical cancer, anal cancer is rare. The National Cancer Institute estimates that 5260 patients will be diagnosed with anal cancer in 2010 and that 720 men and women will die of the disease. 1 Compare this to cervical cancer statistics in the United States for 2010: 12,200 will be diagnosed with cervical cancer and 4210 women will die and this is with successful opportunistic Papanicolaou (Pap) testing to screen for this cancer in the United States. Yet, in patients with the highest risk of anal cancer, its incidence was more than double that of cervical cancer prior to the initiation of Pap screening and is increasing, while rates for cervical cancer continue to decrease. As the incidence of anal carcinoma increases in populations at risk, cytologic screening, combined with early detection and treatment, has been proposed as a method to reduce the morbidity and mortality from invasive anal squamous cell carcinoma (ASCC).

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“…Os tipos 5,8,16,18, 31 e 45 do HPV são os mais comuns na região anogenital e são considerados como oncogênicos. As oncoproteínas E6 desses tipos virais interagem com a E6AP ubiquitina ligase e se ligam a várias proteínas celulares, incluindo a p53, causando degradação celular 31 .…”

Section: Discussionunclassified

“…Entretanto, sua freqüência é 25 a 50 vezes maior entre os portadores do vírus da imunodeficiência adquirida (HIV), demonstrando mudança na epidemiologia dessa afecção 2,4 . Esse aumento vem sendo notado desde os anos 80, particularmente entre os homossexuais masculinos 5 , e parece estar intimamente associado à infecção pelo Papilomavírus Humano (HPV) [6][7] . Além disso, vários autores acreditam que o esquema de drogas anti-retrovirais, atualmente usado pelos portadores do HIV, aumenta a expectativa de vida desses doentes.…”

Section: Introductionunclassified