scholarly journals Comparing Anal Cancer Screening Algorithms Using Cytology and HPV DNA Testing in Three High-risk Populations

2021 ◽  
Author(s):  
Michael M Gaisa ◽  
Keith M Sigel ◽  
Ashish A DESHMUKH ◽  
Volha LENSKAYA ◽  
Courtney A CHAN ◽  
...  
Keyword(s):  
High Risk ◽  
Anal Cancer ◽  
Dna Testing ◽  
Hpv Dna ◽  
Screening Performance ◽  
Anal Cytology ◽  
High Risk Populations ◽  
Increased Sensitivity ◽  
Sex With Men ◽  
Anal Cancer Screening

Abstract Background Screening strategies for high-risk human papillomavirus (hrHPV)-associated anal cancer are evolving. This study compares the screening performance of anal cytology to hrHPV DNA testing and two novel cytology/hrHPV cotesting algorithms among three high-risk populations. Methods Anal cytology, hrHPV DNA testing, and high-resolution anoscopy (HRA)-guided biopsy results were analyzed from 1,837 participants comprising 1,504 HIV-infected men who have sex with men (MSM), 155 HIV-uninfected MSM, and 178 HIV-infected women. Screening performance to detect histological high-grade squamous intraepithelial lesions (HSIL)/cancer was compared between four strategies with distinct HRA referral thresholds: cytology (ASCUS); hrHPV testing (any hrHPV+); algorithm A (benign cytology/HPV16/18+ or ASCUS/hrHPV+); and algorithm B (benign or ASCUS cytology/hrHPV+). Results Histological HSIL/cancer was detected in 756 (41%) participants. Cytology alone had the lowest sensitivity (0.76-0.89) but the highest specificity (0.33-0.36) overall and for each subgroup. Algorithm B was the most sensitive strategy overall (0.97) and for MSM (HIV-infected 0.97; HIV-uninfected 1.00). For HIV-infected women, hrHPV testing and both algorithms yielded higher sensitivity than cytology (0.96, 0.98, and 0.96). Specificity was low for all strategies and subgroups (range 0.16-0.36). Conclusions Screening algorithms that incoporate cytology and hrHPV testing significantly increased sensitivity and further decreased specificity to detect anal precancer/cancer among high-risk populations.

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.

Factors associated with self-reported anal cancer screening history in men who have sex with men

Sexual Health ◽  
2019 ◽  
Vol 16 (1) ◽  
pp. 96 ◽  
Author(s):  
Joseph T. Hicks ◽  
Lu-Yu Hwang ◽  
Sarah Baraniuk ◽  
Margaret White ◽  
Elizabeth Y. Chiao ◽  
...  
Keyword(s):  
Cancer Screening ◽  
Anal Cancer ◽  
Multivariable Analysis ◽  
Computer Assisted ◽  
National Guidelines ◽  
Cancer Data ◽  
Factors Associated ◽  
Anal Cytology ◽  
Sex With Men ◽  
Anal Cancer Screening

Background Men who have sex with men (MSM) are at greater risk of developing anal cancer caused by human papillomavirus (HPV) than the rest of the general population. Currently, there are no formal national guidelines in the US advising men how and when to get anal cancer screening. We sought to assess differences in demographics, familiarity and anxiety about anal cancer among men who report having had anal cancer screening (i.e. anal cytology and/or a digital anorectal examination (DARE)). Methods: MSM were recruited to participate in a study to assess the feasibility of teaching self and partner anal examinations as a means of screening for anal cancer. Data for this secondary analysis were obtained using a written pre-test and a computer-assisted self-interview. Factors associated with screening were assessed with multivariable logistic regression to allow calculation of adjusted odds ratios (aORs). Results: Of the 197 participants with data, 145 (73.6%) reported having had anal cancer screening (either anal cytology, DARE or both) during their lifetime. Men who were younger, Black and HIV-negative were associated with decreased odds of reporting any type of anal cancer screening. For example, compared with White men, Black men were 80% less likely to report screening (aOR 0.2; 95% confidence interval (CI) 0.1–0.5). Self-perception of anal cancer knowledge was not associated with screening in multivariable analysis (aOR 1.6; 95% CI 0.6–3.9). Conclusions: Age, race and HIV status were independently associated with a history of anal cancer screening.

scholarly journals Comparison of Hybribio GenoArray and Roche Human Papillomavirus (HPV) Linear Array for HPV Genotyping in Anal Swab Samples

2014 ◽  
Vol 53 (2) ◽  
pp. 550-556 ◽  
Author(s):  
Huey Chi Low ◽  
Michelle I. Silver ◽  
Brandon J. Brown ◽  
Chan Yoon Leng ◽  
Magaly M. Blas ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Anal Cancer ◽  
Linear Array ◽  
Kappa Statistics ◽  
Hpv Dna ◽  
Resource Limited ◽  
Hpv Genotypes ◽  
Anal Swab ◽  
Sex With Men ◽  
Anal Cancer Screening

Human papillomavirus (HPV) is causally associated with anal cancer, as HPV DNA is detected in up to 90% of anal intraepithelial neoplasias and anal cancers. With the gradual increase of anal cancer rates, there is a growing need to establish reliable and clinically relevant methods to detect anal cancer precursors. In resource-limited settings, HPV DNA detection is a potentially relevant tool for anal cancer screening. Here, we evaluated the performance of the Hybribio GenoArray (GA) for genotyping HPV in anal samples, against the reference standard Roche Linear Array (LA). Anal swab samples were obtained from sexually active men who have sex with men. Following DNA extraction, each sample was genotyped using GA and LA. The overall interassay agreement, type-specific, and single and multiple genotype agreements were evaluated by kappa statistics and McNemar's χ2tests. Using GA and LA, 68% and 76% of samples were HPV DNA positive, respectively. There was substantial interassay agreements for the detection of all HPV genotypes (κ = 0.70, 86% agreement). Although LA was able to detect more genotypes per sample, the interassay agreement was acceptable (κ = 0.53, 63% agreement). GA had poorer specific detection of HPV genotypes 35, 42, and 51 (κ < 0.60). In conclusion, GA and LA showed good interassay agreement for the detection of most HPV genotypes in anal samples. However, the detection of HPV DNA in up to 76% of anal samples warrants further evaluation of its clinical significance.

mRNA Biomarker in Anal Cytology: A Feasible Approach for Anal Cancer Screening in Men Who Have Sex with Men Living with HIV

2019 ◽  
Author(s):  
Marta del Pino ◽  
Cristina Mart&iacute; ◽  
Jina Gaber ◽  
Cecilia Svanholm-Barrie ◽  
Leonardo Rodr&iacute;guez-Caruchio ◽  
...  
Keyword(s):  
Cancer Screening ◽  
Anal Cancer ◽  
Anal Cytology ◽  
Sex With Men ◽  
Anal Cancer Screening ◽  
Living With Hiv
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