Cost-effectiveness of screening for anal squamous intraepithelial lesions and anal cancer in human immunodeficiency virus–negative homosexual and bisexual men

2000 ◽  
Vol 108 (8) ◽  
pp. 634-641 ◽  
Author(s):  
Sue J Goldie ◽  
Karen M Kuntz ◽  
Milton C Weinstein ◽  
Kenneth A Freedberg ◽  
Joel M Palefsky
Keyword(s):  
Human Immunodeficiency Virus ◽  
Cost Effectiveness ◽  
Anal Cancer ◽  
Bisexual Men ◽  
Squamous Intraepithelial Lesions ◽  
Immunodeficiency Virus ◽  
Anal Squamous Intraepithelial Lesions ◽  
And Bisexual ◽  
Intraepithelial Lesions

Anal Squamous Intraepithelial Lesions (SILs) in Human Immunodeficiency Virus–Positive Men Who Have Sex With Men: Incidence and Risk Factors of SIL and of Progression and Clearance of Low-Grade SILs

2019 ◽  
Vol 222 (1) ◽  
pp. 62-73 ◽  
Author(s):  
V W Jongen ◽  
O Richel ◽  
E Marra ◽  
M L Siegenbeek van Heukelom ◽  
A van Eeden ◽  
...  
Keyword(s):  
Risk Factors ◽  
Human Immunodeficiency Virus ◽  
Hiv Positive ◽  
Low Grade ◽  
Squamous Intraepithelial Lesions ◽  
Immunodeficiency Virus ◽  
Anal Squamous Intraepithelial Lesions ◽  
Sex With Men ◽  
Intraepithelial Lesions

Abstract Background Human immunodeficiency virus (HIV)–positive men who have sex with men (MSM) are at risk of anal squamous cell carcinoma. Data are limited on the natural history of the precursor to this carcinoma, anal squamous intraepithelial lesions (SILs). Methods HIV-positive MSM were screened for histopathological SILs by means of high-resolution anoscopy (HRA). For participants without SILs at baseline, we estimated the cumulative incidence and risk factors for SILs. For those with low-grade SILs (LSILs) at baseline, the risk of progression to high-grade SILs (HSILs) and the clearance rate were estimated at the lesion level. Results Of 807 men without SILs at baseline, 107 underwent follow-up HRA between 1 to 4.5 years later. At the second visit 18 men (16.8%) showed LSIL, and 25 (23.4%) HSIL. Age was associated with incident LSILs (adjusted odds ratio [aOR], 2.10 per 10-year increase in age; P = .01). Of 393 men with LSILs at baseline, 114 underwent follow-up HRA 0.5 to 2.5 years later. Of the 177 LSILs found at baseline, 87 (49.2%) had cleared at the second visit, and 29 (16.4%) had progressed to HSILs. Conclusion Incident LSILs and HSILs were common during follow-up among HIV-positive MSM without dysplasia at baseline. Among men with LSILs at baseline, nearly half of these lesions cleared, and a small portion progressed.

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