Prevalence of Abnormal Anal Cytology in Women with Abnormal Cervical Cytology

Abstract

Objective: The aim of this study was to evaluate the prevalence of abnormal anal cytology in women presenting with abnormal cervical cytology (intraepithelial lesion or cervical cancer) at the largest tertiary university hospital in Thailand. Methods: A cross-sectional prospective study design was used. Anal cytology was performed on 145 women with abnormal cervical cytology between June 2014-Octoble 2014. If abnormal anal cytology was detected, anoscopy was performed with biopsy in any suspicious area of precancerous change. Results: Prevalence of abnormal anal cytology was 5.5% (8 patients). Of 8 patients, six patients presented with low-grade squamous intraepithelial lesion, one patient with high-grade squamous intraepithelial lesion, and one with atypical squamous cell cannot exclude highgrade squamous intraepithelial lesion. Abnormal anoscopic impression was found in 3 cases, as follow: The first case showed faint acetowhite lesion and anoscopic impression was low grade squamous intraepithelial lesion; the second case was reported as human papillomavirus (HPV) change by anoscopic impression; and the third case showed dense acetowhite lesion with multiple punctation and pathologic examination showed anal intraepithelial neoplasm III (AIN3). The last patient underwent wide local excision of AIN3 with split-thickness skin graft reconstruction. Final pathology confirmed AIN3 with free resection margin. Conclusion: Prevalence of abnormal anal cytology was 5.5% in patients with abnormal cervical cytology. The prevalence might be support anal cytology screening in this group of patients.

Evaluation of anal cytology and human papillomavirus infection in high-risk women: a cross-sectional study

“…In line with Tatti et al's 7 and Hosseini et al's 8 findings, this study found anal sex as a significant risk factor for anal cancer, with a significant association with anal dysplasia (p = 0.001) and positive anal HPV test results (p<0.001). However, Inthasorn et al 10 and Calore et al 14 found no significant association between anal intercourse and anal dysplasia.…”

“…Inthasorn et al 10 found that anal dysplasia was not associated with marital status or multiple sexual partnerships, although multiparity was associated with a higher rate of abnormal anal cytology. However, multiple sexual partnerships could increase the risk of anal cancer.…”

“…Although anal cancer is rare, its prevalence has increased in the past three decades, with a higher incidence rate in women. 10 Anal cancers mostly include SCC, followed by adenocarcinomas and melanomas. Despite the success of cervical cancer screening and vaccination programs, the rising incidence of anal cancer requires preventive measures.…”

“…Moreover, anal HPV infection was similar to cervical infection; therefore, the cervix may be a reservoir for anal infection and vice versa. 9,10 Moreover, recent evidence has demonstrated that the prevalence of HPV 16 in anal cancer was higher than other types of high-risk HPV (HR-HPV). Although in low-grade and high-grade lesions, other types of HR-HPV also accounted for a high proportion.…”

Concurrent anorectal and cervical cytology in women with positive and negative cervical smear test results: A cross‐sectional study

“…In a recent study, 12 anal cytology was performed in 145 women with abnormal cervical cytology. The authors estimated the prevalence of abnormal anal cytology at 5.5%.…”