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.

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.

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 Knowledge of Anal Cancer, Anal Cancer Screening, and HPV in HIV-Positive and High-Risk HIV-Negative Women

2019 ◽  
Vol 35 (3) ◽  
pp. 606-615 ◽  
Author(s):  
Jessica S. Wells ◽  
Lisa Flowers ◽  
Sudeshna Paul ◽  
Minh Ly Nguyen ◽  
Anjali Sharma ◽  
...  
Keyword(s):  
Cancer Screening ◽  
High Risk ◽  
Anal Cancer ◽  
Hiv Positive ◽  
Anal Cancer Screening ◽  
Hiv Negative

scholarly journals Anal Cancer Screening Attitudes and Practices in Maryland Healthcare Providers: Implications for National Trends

2019 ◽  
pp. 1-8
Author(s):  
Sophia Y. Chen ◽  
Ira L. Leeds ◽  
Marcelo Cerullo ◽  
Joyce L. Jones ◽  
Ulrike K. Buchwald ◽  
...  
Keyword(s):  
Primary Care ◽  
Cancer Screening ◽  
High Risk ◽  
Anal Cancer ◽  
Healthcare Providers ◽  
Organ Transplant Recipient ◽  
Team Approach ◽  
Attitudes And Practices ◽  
Hpv Test ◽  
Anal Cancer Screening

Background: Anal cancer incidence is increasing in the US. Though formally established national anal cancer screening guidelines are nonexistent, many providers advocate screening to avoid late disease presentation. This study assesses the knowledge, attitudes, and practices of anal cancer screening among providers to identify the degree of variation and barriers to screening. Methods: Healthcare providers from two academic medical centers and a statewide community primary care group were surveyed using a questionnaire adapted from the National Survey of Primary Care Physicians’ Recommendations and Practice for Cancer Screening. Descriptive statistics were performed to explore providers’ responses and Fisher’s exact test to explore variation. Results: 86 providers completed the questionnaire (response rate 24.2%): 81.4% physicians, 18.6% advanced practitioners. 48.2% of respondents perform anal cancer screening. 5.8% correctly identified all high-risk patient factors. “HIV+ patient” was identified most frequently as high-risk (93.5%), “organ transplant recipient” (42.9%) least frequently. Anal pap test was the most recommended first-line screening test (76.6%) followed by digital anorectal exam (19.2%), HPV test (8.5%), and high-resolution anoscopy (HRA) (6.4%). Clinical evidence (72.3%) and national guidelines (70.2%) were most influential in guiding providers’ screening recommendations. Lack of qualified screening providers (34.1%), lack of patient follow-up after positive test results (22.7%), and patient non-compliance to initial screening (15.9%) were identified as “usual” barriers. Conclusions: Anal cancer screening attitudes and practices vary among providers. Development of national practice guidelines that define a multidisciplinary team approach from primary care anal cancer screening to specialist referral for HRA may reduce screening variability.

The role of cytology (Pap tests) and human papillomavirus testing in anal cancer screening

AIDS ◽  
2010 ◽  
pp. 1 ◽  
Author(s):  
Irving E Salit ◽  
Alice Lytwyn ◽  
Janet Raboud ◽  
Marie Sano ◽  
Sylvia Chong ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Cancer Screening ◽  
Anal Cancer ◽  
Pap Tests ◽  
Human Papillomavirus Testing ◽  
Anal Cancer Screening

scholarly journals High-risk human papillomavirus in anal squamous cell carcinoma: a ‘conservative’ leading role

2017 ◽  
Vol 28 (5) ◽  
pp. 1160
Author(s):  
P.S. Ravenda ◽  
M.G. Zampino ◽  
E. Guerini-Rocco ◽  
S. Chiocca ◽  
V. Dell’Acqua ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Human Papillomavirus ◽  
High Risk ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Anal Squamous Cell Carcinoma ◽  
Leading Role
Sign in / Sign up

Export Citation Format

Share Document