Prevalence of high‐risk human papillomavirus DNA and mRNA and its association with abnormal anal cytology in the Czech male anal cancer screening cohort

2021 ◽  
Author(s):  
Jana Nemcova ◽  
Katerina Cerna ◽  
Filip Rob ◽  
Jana Smahelova ◽  
Jana Tresnak Hercogova ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Cancer Screening ◽  
High Risk ◽  
Anal Cancer ◽  
Anal Cytology ◽  
Anal Cancer Screening ◽  
Papillomavirus Dna

Cytology in Anal Cancer Screening: Practical Review for Clinicians

2019 ◽  
Vol 64 (4) ◽  
pp. 281-287 ◽  
Author(s):  
Andreia Albuquerque
Keyword(s):  
Cancer Screening ◽  
High Risk ◽  
Anal Cancer ◽  
Risk Groups ◽  
Hiv Positive ◽  
Solid Organ ◽  
Anal Squamous Cell Carcinoma ◽  
Incidence And Mortality ◽  
Anal Cytology ◽  
Anal Cancer Screening

The incidence and mortality of anal squamous cell carcinoma (SCC) are expected to continue to increase in the next 20 years. High-risk groups for anal SCC, i.e., human immunodeficiency virus (HIV)-positive patients, men who have sex with men (MSM), women with previous genital neoplasia, and solid-organ transplant recipients, have been identified. HIV-positive MSM have the highest risk, and some societies have advocated for anal cancer screening to be done in this population. Screening for anal SCC follows the same principles as that for cervical cancer since there are similarities between the two types of cancers. Anal cytology has been recommended as an initial screening method for high-risk groups, e.g., HIV-positive MSM. Normally, the cytology is liquid based and collected blindly by a clinician using a Dacron swab and it is especially used for internal lesions detection. The sensitivity to predict anal high-grade squamous intraepithelial lesions is higher in immunosuppressed patients with a high burden of the disease. The report should include the classification, normally according to the Bethesda terminology and the sample adequacy, in a manner similar to that for cervical cytology. In cases involving unsatisfactory samples, it is important to repeat the procedure given the prevalence of anal squamous cytological abnormalities in follow-up cytology procedures. The absence of transformation zone cells in anal cytology seems to increase the risk of false-negative results.

scholarly journals Recommendations Favoring Anal Cytology as a Method for Anal Cancer Screening: A Systematic Review

Cancers ◽  
2019 ◽  
Vol 11 (12) ◽  
pp. 1942 ◽  
Author(s):  
Andreia Albuquerque ◽  
Elisabete Rios ◽  
Fernando Schmitt
Keyword(s):  
Cancer Screening ◽  
High Risk ◽  
Anal Cancer ◽  
Risk Groups ◽  
The United States ◽  
Hiv Positive ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Anal Cytology ◽  
Anal Cancer Screening

Clinicians are increasingly facing the decision of performing anal cancer screening in high-risk groups. Anal cytology is commonly the first approach. We systematically reviewed recommendations favoring anal cytology for anal cancer screening. Three databases were searched: PubMed, Scopus, and Embase, from January 2007 to 12 September 2019. The references cited by the retrieved articles and the websites of relevant organizations were also searched without language restrictions. Studies reporting guidelines from regional or national societies, institutes, or groups were included. Eight papers met the inclusion criteria and were selected, five were from the United States of America (USA) and three from Europe. There were no national recommendations published. There was one guideline specifically for solid-organ transplant recipients. The other seven targeted HIV-positive patients, with HIV-positive men who have sex with men (MSM) included as a screening group in all of these. Two recommendations favored screening in all HIV-positive patients. Five recommendations targeting HIV-positive patients made considerations about the cytology follow-up, recommending at least annual cytology in case of a normal result, and in case of squamous cytological abnormalities, a referral for anoscopy/high-resolution anoscopy. There were no recommendations for upper and lower age limits for screening. In conclusion, several societies recommend anal cancer screening using anal cytology in HIV-positive MSM patients. There is a lack of screening recommendations for other high-risk groups, with only one society recommending screening in transplant recipients.

New Insights into the Role of Human Papillomavirus in Anal Cancer and Anal Wart Development

2019 ◽  
Vol 63 (2) ◽  
pp. 118-123 ◽  
Author(s):  
Andreia Albuquerque ◽  
Rui Medeiros
Keyword(s):  
Human Papillomavirus ◽  
Cancer Screening ◽  
High Risk ◽  
Anal Cancer ◽  
Squamous Cell ◽  
Benign Lesion ◽  
Premalignant Lesions ◽  
Solid Organ ◽  
Anal Squamous Cell Carcinoma ◽  
Anal Cancer Screening

Human papillomavirus is associated with several anogenital and oropharyngeal lesions, including warts, premalignant lesions, and cancer. There are specific groups that were identified as high-risk groups for anal squamous cell carcinoma and anal human papillomavirus infection, namely HIV-positive patients, men who have sex with men, women with genital tract neoplasia, and solid organ transplant recipients. Condylomas have classically been considered to be a benign lesion, with an exception made for the Buschke-Loewenstein tumor, but several publications have shown that a high percentage of condylomas harbor high-grade lesions. Due to the similarities between anal and cervical carcinogenesis, anal cancer screening based on anal cytology and referral to high-resolution anoscopy, in case of abnormalities, have been advocated. Testing for anal human papillomavirus is not routinely done in anal cancer screening, because of the very high prevalence in high-risk populations. The large majority of anal cancers are squamous cell carcinomas (SCC), and around 90% are attributed to human papillomavirus. Human papillomavirus positivity in anal SCC seems to have a prognostic value, with better survival in those patients with positive tumors. Prophylactic vaccination has been shown to be important for prevention of anal human papillomavirus-related lesions.

scholarly journals Acceptability of anal cancer screening tests for women living with HIV in the EVVA study

2020 ◽  
Vol 27 (1) ◽  
Author(s):  
E. Kaufman ◽  
C. De Castro ◽  
T. Williamson ◽  
B. Lessard ◽  
M. Munoz ◽  
...  
Keyword(s):  
Cancer Screening ◽  
Anal Cancer ◽  
Screening Tests ◽  
Adult Women ◽  
Hpv Testing ◽  
Women Living With Hiv ◽  
Cancer Screening Tests ◽  
Anal Cytology ◽  
Anal Cancer Screening ◽  
Living With Hiv

Background Anal cancer is potentially preventable through screening. For screening to be implemented, the screening procedures must be acceptable to the affected population. The objective of the present study was to measure the acceptability of currently available anal cancer screening tests in a population of women living with hiv who had experienced the tests.Methods The evva study (“Evaluation of Human Immunodeficiency Virus, Human Papillomavirus, and Anal Intraepithelial Neoplasia in Women”) is a prospective cohort study of adult women living with hiv in Montreal, Quebec. Participants were screened with cervical or anal hpv testing and cervical or anal cytology every 6 months for 2 years. High-resolution anoscopy (hra) and digital anal rectal examination (dare) were also performed systematically, with biopsies, at baseline and at 2 years. An acceptability questionnaire was administered at the final visit or at study withdrawal.Results Of 124 women who completed the acceptability questionnaire, most considered screening “an absolute necessity” in routine care for all women living with hiv [77%; 95% confidence interval (ci): 69% to 84%]. Yearly anal cytology or anal hpv testing was considered very acceptable by 81% (95% ci: 73% to 88%); hra every 2 years was considered very acceptable by 84% (95% ci: 77% to 90%); and yearly dare was considered very acceptable by 87% (95% ci: 79% to 92%). Acceptability increased to more than 95% with a longer proposed time interval. Pain was the main reason for lower acceptability.Conclusions Most participating women considered anal cancer screening necessary and very acceptable. Longer screening intervals and adequate pain management could further increase the acceptability of repeated screening.

scholarly journals Anal cancer screening in a high-risk behavior group: A local picture

2020 ◽  
Vol 40 (2) ◽  
pp. 156-162
Author(s):  
Fernanda Elias Ferreira Rabelo ◽  
Fábio Henrique de Oliveira ◽  
Bárbara Diniz Greco de Melo ◽  
Eduardo Rafael Oliveira Borges ◽  
Nicholas Resende Pena ◽  
...  
Keyword(s):  
Cancer Screening ◽  
High Risk ◽  
Risk Behavior ◽  
Anal Cancer ◽  
High Risk Behavior ◽  
Group A ◽  
Anal Cancer Screening

scholarly journals The Diagnostic Value of p16/Ki67 Dual Immunostaining for Anal Intraepithelial Neoplasia: A Meta-Analysis

2020 ◽  
Vol 14 (6) ◽  
pp. 155798832097763
Author(s):  
Cheng-Chieh Chen ◽  
Kuan-Chun Hsueh ◽  
Cheng-Huang Shen ◽  
Chyi-Huey Bai ◽  
Chia-Chang Wu ◽  
...  
Keyword(s):  
Cancer Screening ◽  
Anal Cancer ◽  
Meta Analysis ◽  
Screening Method ◽  
Intraepithelial Neoplasia ◽  
Anal Intraepithelial Neoplasia ◽  
Cochrane Library ◽  
Sufficient Information ◽  
Anal Cytology ◽  
Anal Cancer Screening

The p16/Ki67 dual immunostaining was performed on anal cytology specimens; this is an anal cancer screening method. A literature search was performed in the BioMed Central, Cochrane Library, Embase, Google Scholar, and PubMed electronic databases for relevant articles. We included studies that discussed the efficacy of p16/Ki67 dual immunostaining for detecting anal intraepithelial neoplasia (AIN). Studies that calculated the diagnostic efficacy on a per-patient basis were included. We excluded review articles, case series, and studies that did not provide sufficient information. We extracted data on true positive, true negative, false positive, and false negative from the included studies to generate pooled sensitivity, specificity, and diagnostic odds ratio (DOR). All analyses were performed with a random-effects model using MetaDiSc 1.4 and MetaDTA. The meta-analysis produced a pooled sensitivity of 0.63 (95% CI: 0.34, 0.86) and specificity of 0.65 (95% CI: 0.46, 0.81) for p16/Ki67 dual immunostaining in detecting AIN. The pooled DOR was 3.26 (95% CI: −0.29, 6.82). A subgroup analysis of HIV-infected men who have sex with men (MSM) demonstrated a pooled sensitivity of 0.75 (95% CI: 0.28, 0.96). p16/Ki67 dual immunostaining might have a higher sensitivity for detecting AIN in HIV-infected MSM. p16/Ki67 dual immunostaining might be more sensitive in HIV-infected MSM and has higher specificity compared to human papillomavirus testing among this high-risk group. p16/Ki67 dual immunostaining might be an adjuvant and potential triage test for anal cytology in anal cancer screening.

38. Anal cancer screening in HIV primary care: uptake and outcomes

Sexual Health ◽  
2013 ◽  
Vol 10 (6) ◽  
pp. 588 ◽  
Author(s):  
Irving E. Salit ◽  
Sandra Blitz ◽  
Evan Collins ◽  
Banita Aggarwal ◽  
Janet Raboud ◽  
...  
Keyword(s):  
Primary Care ◽  
Cancer Screening ◽  
Anal Cancer ◽  
High Grade ◽  
Anal Cytology ◽  
Hiv Primary Care ◽  
Anal Cancer Screening ◽  
Primary Care Practices ◽  
To Receive ◽  
Intraepithelial Lesions

Background Anal cytology (Pap tests) plus high-resolution anoscopy (HRA) as required are felt to be the optimal approach to anal cancer screening. We present preliminary results from STANDOUT, a study of acceptability and outcomes of anal cancer screening of HIV+ MSM in primary care practices. Methods: All previously unscreened HIV+ MSM from 9 HIV primary care practices, were invited by email or letter to receive anal cancer screening. Responders had anal cytology done at specially arranged or routine clinic visits. Those with high-grade squamous intraepithelial lesions (HSIL) on anal cytology were offered HRA to assess for anal intraepithelial neoplasia (AIN). Those with AIN 2/3 on biopsy were randomised to receive trichloroacetic acid (TCA) or infrared coagulator (IRC) treatments. Results: 1733 patients were invited and 921 (53%) agreed to have anal cytology done. Among those screened, 3 had unsatisfactory samples; 596 (65%) had normal cytology, 253 (27%) had low-grade squamous intraepithelial lesions (LSIL) and 69 (7.5%) had HSIL. HRA results are available in 64: 41 (64%) had histologic high-grade disease (29 had AIN2 and 12 had AIN3). Those with AIN 2/3 were randomised to receive treatment with TCA (16 patients) or IRC (18 patients). Treatment successes at 3 months were 6 of 15 patients for TCA (40%) and 11 of 16 patients for IRC (69%). Conclusions: In this sample of HIV+ MSM, about half of those invited for anal cancer screening agreed to have it done. Most with HSIL had histological high-grade disease and were treated. IRC was more successful than TCA at ablating high-grade disease.

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