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.

Abstract C126: Challenges implementing anal cancer screening for women living with HIV: Clinical providers and staff perspectives

2020 ◽  
Author(s):  
Serena A Rodriguez ◽  
Robin T Higashi ◽  
Andrea B Betts ◽  
Cynthia Ortiz ◽  
Jasmin A Tiro ◽  
...  
Keyword(s):  
Cancer Screening ◽  
Anal Cancer ◽  
Women Living With Hiv ◽  
Anal Cancer Screening ◽  
Living With Hiv

scholarly journals Anal Cancer and Anal Cancer Screening Knowledge, Attitudes, and Perceived Risk Among Women Living With HIV

2020 ◽  
Vol 25 (1) ◽  
pp. 43-47
Author(s):  
Serena A. Rodriguez ◽  
Robin T. Higashi ◽  
Andrea C. Betts ◽  
Cynthia Ortiz ◽  
Jasmin A. Tiro ◽  
...  
Keyword(s):  
Cancer Screening ◽  
Anal Cancer ◽  
Perceived Risk ◽  
Women Living With Hiv ◽  
Anal Cancer Screening ◽  
Living With Hiv

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 Martí ◽  
Jina Gaber ◽  
Cecilia Svanholm-Barrie ◽  
Leonardo Rodríguez-Caruchio ◽  
...  
Keyword(s):  
Cancer Screening ◽  
Anal Cancer ◽  
Anal Cytology ◽  
Sex With Men ◽  
Anal Cancer Screening ◽  
Living With Hiv

scholarly journals mRNA Detection in Anal Cytology: A Feasible Approach for Anal Cancer Screening in Men Who Have Sex with Men Living With HIV

Diagnostics ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. 173
Author(s):  
Pino ◽  
Martí ◽  
Gaber ◽  
Svanholm-Barrie ◽  
Rodríguez-Carunchio ◽  
...  
Keyword(s):  
Cancer Screening ◽  
Anal Cancer ◽  
Intraepithelial Neoplasia ◽  
Low Grade ◽  
Mrna Detection ◽  
Hpv Test ◽  
Screening Strategies ◽  
Sex With Men ◽  
Anal Cancer Screening ◽  
Living With Hiv

There is growing interest in anal cancer screening strategies. However, cytological/molecular evaluation of anal samples is challenging. We aimed to determine the feasibility of detecting, in anal liquid-based cytologies, the expression of biomarkers involved in the cell cycle disturbance elicited by human papillomavirus (HPV). The accuracy of this approach in the identification of high-grade squamous intraepithelial lesions/anal intraepithelial neoplasia grade2–3 (HSIL/AIN2–3) was also evaluated. 215 anal cytologies from men having sex with men living with human immunodeficiency virus were evaluated. Patients showing concordant cytological and anoscopy-directed biopsy diagnosis were selected: 70 with negative cytology and HPV test, 70 with low-grade SIL (LSIL/AIN1) cytology and biopsy, and 75 with cytology and biopsy of HSIL/AIN2–3. CDKN2A/p16, MKI67 and TOP2A mRNA expression was analyzed. HPV detection was performed with Xpert HPV Assay (Cepheid, Sunnyvale, CA, USA). HSIL/AIN2–3 showed higher expression for the biomarkers than LSIL/AIN1 or negative samples. The specificity for HSIL/AIN2–3 detection for a sensitivity established at 70% was 44.7% (95%confidence interval [CI] 36.5–53.2) for TOP2A and MKI67 and 54.5% (95%CI 46.0–62.8%) for CDKN2A/p16. mRNA detection of cell biomarkers in anal liquid-based cytology is feasible. Further studies are warranted to confirm if strategies based on mRNA detection have any role in anal cancer screening.

20. Utility of human papillomavirus (HPV) 16 E6 and L1 DNA levels for anal cancer screening in HIV-infected individuals

Sexual Health ◽  
2013 ◽  
Vol 10 (6) ◽  
pp. 580 ◽  
Author(s):  
Doreen Lee ◽  
Mark H. Einstein ◽  
Rebecca A. Levine ◽  
Mark J. Suhrland ◽  
Samer Khader ◽  
...  
Keyword(s):  
Cancer Screening ◽  
Anal Cancer ◽  
Pap Smear ◽  
Standard Of Care ◽  
Molecular Testing ◽  
Hpv Testing ◽  
Hpv16 E6 ◽  
Screening Programs ◽  
Anal Cancer Screening ◽  
Better Than

Background In this prospective study we evaluate the sampling performance of HPV16 DNA E6 and L1 levels in detecting anal intraepithelial neoplasm using either a moistened Dacron swab (DS) or cytobrush (CB). Methods: We recruited HIV-infected (n = 57) and organ-transplanted subjects (n = 3) with an abnormal anal Pap smear who presented for high-resolution anoscopy (HRA). Prior to HRA, the first 30 subjects underwent sampling with a moistened DS, and the next 30 with a CB. HRA was then performed in the usual fashion. Samples were tested for HPV16 DNA E6 and L1 DNA using a validated qPCR technique. Anal biopsies were taken as per standard-of-care and categorised as negative, AIN 1/warts, or AIN 2 or 3. Results: 59 of 60 samples had adequate DNA and were evaluated for the comparison of HPV16 E6 and L1 DNA levels. A CB performed better than the DS in detecting low positive and positive levels of HPV16 E6 DNA (P = 0.01). We then further evaluated the correlation of HRA-directed biopsies and HPV16 DNA E6 levels. There was a positive correlation of HRA-directed biopsy results stratified by increasing histological levels with HPV16 E6 DNA (P = 0.018, Kruskal–Wallis test). Conclusions: A CB performed better than DS for molecular HPV testing. If molecular testing is included in anal cancer screening, consideration should be made for co-sampling with both a DS for cytology and CB for HPV testing. Further studies evaluating the sample yields should be performed to assist in implementation of anal cancer screening programs in defined populations of at-risk individuals.

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 Racial disparities in anal cancer screening among men living with HIV

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Jennifer L. Gillis ◽  
Troy Grennan ◽  
Ramandip Grewal ◽  
Gina Ogilvie ◽  
Mark Gaspar ◽  
...  
Keyword(s):  
Cancer Screening ◽  
Racial Disparities ◽  
Anal Cancer ◽  
Anal Cancer Screening ◽  
Living With Hiv

scholarly journals Costs and cost-effectiveness of cervical cancer screening strategies in women living with HIV in Burkina Faso: The HPV in Africa Research Partnership (HARP) study

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248832
Author(s):  
Angela Devine ◽  
Alice Vahanian ◽  
Bernard Sawadogo ◽  
Souleymane Zan ◽  
Fadima Yaya Bocoum ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Burkina Faso ◽  
Cervical Cancer Screening ◽  
Visual Inspection ◽  
Screening Tests ◽  
Research Partnership ◽  
Women Living With Hiv ◽  
Screening Strategies ◽  
Living With Hiv

Introduction This study estimated the costs and incremental cost per case detected of screening strategies for high-grade cervical intraepithelial neoplasia (CIN2+) in women living with HIV (WLHIV) attending HIV clinics in Burkina Faso. Methods The direct healthcare provider costs of screening tests (visual inspection with acetic acid (VIA), VIA combined visual inspection with Lugol’s iodine (VIA/VILI), cytology and a rapid HPV DNA test (careHPV)) and confirmatory tests (colposcopy, directed biopsy and systematic four-quadrant (4Q) biopsy) were collected alongside the HPV in Africa Research Partnership (HARP) study. A model was developed for a hypothetical cohort of 1000 WLHIV using data on CIN2+ prevalence and the sensitivity of the screening tests. Costs are reported in USD (2019). Results The study enrolled 554 WLHIV with median age 36 years (inter-quartile range, 31–41) and CIN2+ prevalence of 5.8%. The average cost per screening test ranged from US$3.2 for VIA to US$24.8 for cytology. Compared to VIA alone, the incremental cost per CIN2+ case detected was US$48 for VIA/VILI and US$814 for careHPV. Despite higher costs, careHPV was more sensitive for CIN2+ cases detected compared to VIA/VILI (97% and 56%, respectively). The cost of colposcopy was US$6.6 per person while directed biopsy was US$33.0 and 4Q biopsy was US$48.0. Conclusion Depending on the willingness to pay for the detection of a case of cervical cancer, decision makers in Burkina Faso can consider a variety of cervical cancer screening strategies for WLHIV. While careHPV is more costly, it has the potential to be cost-effective depending on the willingness to pay threshold. Future research should explore the lifetime costs and benefits of cervical cancer screening to enable comparisons with interventions for other diseases.

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.

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