2 Citations (Scopus)

Abstract

BACKGROUND: Anal cytology may be useful for evaluating lesions associated with human papillomavirus (HPV) in individuals at increased risk for anal cancer. METHODS: Liquid-based cytology was used to assess anal cytological lesions among human immunodeficiency virus (HIV)–infected and HIV-uninfected men who have sex with men (MSM). The Linear Array HPV genotyping test was used for HPV detection. RESULTS: This cross-sectional study included 1021 MSM, of whom 388 were HIV-infected (38.0%). Anal cytological lesions (atypical squamous cells of undetermined significance or more severe [ASCUS+]) were observed in 32.5% and 53.2% of the HIV-uninfected and HIV-infected individuals, respectively (P <.0001). The highest ASCUS + prevalence was observed among ≥45-year-old HIV-uninfected MSM (37.3%) and 25-to 29-year-old HIV-infected MSM (66.7%). High-grade squamous intraepithelial lesions (HSILs) peaked in ≥ 45-year-old HIV-uninfected subjects and 35- to 39-year-old HIV-infected subjects. Individuals with anal infections with high-risk (HR) HPV types were 3 to 4 times more likely to have an ASCUS + report. An HPV-16 and/or HPV-18 infection increased the odds of HSIL or more severe cytology (HSIL+) for HIV-infected MSM almost 4 times. MSM concurrently infected with HR and low-risk HPVs were significantly more likely to have low-grade squamous intraepithelial lesions or more severe cytology (LSIL+) than those infected with only HR types. No significant associations were found between cytological abnormalities and the HIV load and nadir and current CD4 + counts. CONCLUSIONS: The prevalence of anal cytological lesions is high in MSM, even in HIV-infected individuals treated with combined antiretroviral therapy. In these subjects, HSILs occur more frequently and at a younger age in comparison with HIV-uninfected counterparts. Specific diagnostic procedures should be implemented to manage individuals at increased risk for anal cancer with an abnormal anal Papanicolaou test. Cancer Cytopathol 2018;126:461-70.

Original languageEnglish
Pages (from-to)461-470
Number of pages10
JournalCancer cytopathology
Volume126
Issue number7
DOIs
Publication statusPublished - Jul 1 2018

Fingerprint

Anus Neoplasms
Papillomavirus Infections
HIV
Cell Biology
Papanicolaou Test
Human papillomavirus 18
Human papillomavirus 16
CD4 Lymphocyte Count

Keywords

  • anal cancer
  • anal cytology
  • anal neoplasia
  • anal Papanicolaou (Pap) test
  • human immunodeficiency virus (HIV)
  • human papillomavirus
  • men who have sex with men
  • sexually transmitted infection (STI)

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

@article{1c947d564a464d79abcc65a833e743f6,
title = "Anal Cytological Lesions and HPV Infection in Individuals at Increased Risk for Anal Cancer",
abstract = "BACKGROUND: Anal cytology may be useful for evaluating lesions associated with human papillomavirus (HPV) in individuals at increased risk for anal cancer. METHODS: Liquid-based cytology was used to assess anal cytological lesions among human immunodeficiency virus (HIV)–infected and HIV-uninfected men who have sex with men (MSM). The Linear Array HPV genotyping test was used for HPV detection. RESULTS: This cross-sectional study included 1021 MSM, of whom 388 were HIV-infected (38.0{\%}). Anal cytological lesions (atypical squamous cells of undetermined significance or more severe [ASCUS+]) were observed in 32.5{\%} and 53.2{\%} of the HIV-uninfected and HIV-infected individuals, respectively (P <.0001). The highest ASCUS + prevalence was observed among ≥45-year-old HIV-uninfected MSM (37.3{\%}) and 25-to 29-year-old HIV-infected MSM (66.7{\%}). High-grade squamous intraepithelial lesions (HSILs) peaked in ≥ 45-year-old HIV-uninfected subjects and 35- to 39-year-old HIV-infected subjects. Individuals with anal infections with high-risk (HR) HPV types were 3 to 4 times more likely to have an ASCUS + report. An HPV-16 and/or HPV-18 infection increased the odds of HSIL or more severe cytology (HSIL+) for HIV-infected MSM almost 4 times. MSM concurrently infected with HR and low-risk HPVs were significantly more likely to have low-grade squamous intraepithelial lesions or more severe cytology (LSIL+) than those infected with only HR types. No significant associations were found between cytological abnormalities and the HIV load and nadir and current CD4 + counts. CONCLUSIONS: The prevalence of anal cytological lesions is high in MSM, even in HIV-infected individuals treated with combined antiretroviral therapy. In these subjects, HSILs occur more frequently and at a younger age in comparison with HIV-uninfected counterparts. Specific diagnostic procedures should be implemented to manage individuals at increased risk for anal cancer with an abnormal anal Papanicolaou test. Cancer Cytopathol 2018;126:461-70.",
keywords = "anal cancer, anal cytology, anal neoplasia, anal Papanicolaou (Pap) test, human immunodeficiency virus (HIV), human papillomavirus, men who have sex with men, sexually transmitted infection (STI)",
author = "Don{\`a}, {Maria Gabriella} and Maria Benevolo and Alessandra Latini and Francesca Rollo and Manuela Colafigli and Mirko Frasca and Mauro Zaccarelli and Amalia Giglio and Domenico Moretto and Edoardo Pescarmona and Antonio Cristaudo and Massimo Giuliani",
year = "2018",
month = "7",
day = "1",
doi = "10.1002/cncy.22003",
language = "English",
volume = "126",
pages = "461--470",
journal = "Cancer cytopathology",
issn = "1934-662X",
publisher = "John Wiley and Sons Inc.",
number = "7",

}

TY - JOUR

T1 - Anal Cytological Lesions and HPV Infection in Individuals at Increased Risk for Anal Cancer

AU - Donà, Maria Gabriella

AU - Benevolo, Maria

AU - Latini, Alessandra

AU - Rollo, Francesca

AU - Colafigli, Manuela

AU - Frasca, Mirko

AU - Zaccarelli, Mauro

AU - Giglio, Amalia

AU - Moretto, Domenico

AU - Pescarmona, Edoardo

AU - Cristaudo, Antonio

AU - Giuliani, Massimo

PY - 2018/7/1

Y1 - 2018/7/1

N2 - BACKGROUND: Anal cytology may be useful for evaluating lesions associated with human papillomavirus (HPV) in individuals at increased risk for anal cancer. METHODS: Liquid-based cytology was used to assess anal cytological lesions among human immunodeficiency virus (HIV)–infected and HIV-uninfected men who have sex with men (MSM). The Linear Array HPV genotyping test was used for HPV detection. RESULTS: This cross-sectional study included 1021 MSM, of whom 388 were HIV-infected (38.0%). Anal cytological lesions (atypical squamous cells of undetermined significance or more severe [ASCUS+]) were observed in 32.5% and 53.2% of the HIV-uninfected and HIV-infected individuals, respectively (P <.0001). The highest ASCUS + prevalence was observed among ≥45-year-old HIV-uninfected MSM (37.3%) and 25-to 29-year-old HIV-infected MSM (66.7%). High-grade squamous intraepithelial lesions (HSILs) peaked in ≥ 45-year-old HIV-uninfected subjects and 35- to 39-year-old HIV-infected subjects. Individuals with anal infections with high-risk (HR) HPV types were 3 to 4 times more likely to have an ASCUS + report. An HPV-16 and/or HPV-18 infection increased the odds of HSIL or more severe cytology (HSIL+) for HIV-infected MSM almost 4 times. MSM concurrently infected with HR and low-risk HPVs were significantly more likely to have low-grade squamous intraepithelial lesions or more severe cytology (LSIL+) than those infected with only HR types. No significant associations were found between cytological abnormalities and the HIV load and nadir and current CD4 + counts. CONCLUSIONS: The prevalence of anal cytological lesions is high in MSM, even in HIV-infected individuals treated with combined antiretroviral therapy. In these subjects, HSILs occur more frequently and at a younger age in comparison with HIV-uninfected counterparts. Specific diagnostic procedures should be implemented to manage individuals at increased risk for anal cancer with an abnormal anal Papanicolaou test. Cancer Cytopathol 2018;126:461-70.

AB - BACKGROUND: Anal cytology may be useful for evaluating lesions associated with human papillomavirus (HPV) in individuals at increased risk for anal cancer. METHODS: Liquid-based cytology was used to assess anal cytological lesions among human immunodeficiency virus (HIV)–infected and HIV-uninfected men who have sex with men (MSM). The Linear Array HPV genotyping test was used for HPV detection. RESULTS: This cross-sectional study included 1021 MSM, of whom 388 were HIV-infected (38.0%). Anal cytological lesions (atypical squamous cells of undetermined significance or more severe [ASCUS+]) were observed in 32.5% and 53.2% of the HIV-uninfected and HIV-infected individuals, respectively (P <.0001). The highest ASCUS + prevalence was observed among ≥45-year-old HIV-uninfected MSM (37.3%) and 25-to 29-year-old HIV-infected MSM (66.7%). High-grade squamous intraepithelial lesions (HSILs) peaked in ≥ 45-year-old HIV-uninfected subjects and 35- to 39-year-old HIV-infected subjects. Individuals with anal infections with high-risk (HR) HPV types were 3 to 4 times more likely to have an ASCUS + report. An HPV-16 and/or HPV-18 infection increased the odds of HSIL or more severe cytology (HSIL+) for HIV-infected MSM almost 4 times. MSM concurrently infected with HR and low-risk HPVs were significantly more likely to have low-grade squamous intraepithelial lesions or more severe cytology (LSIL+) than those infected with only HR types. No significant associations were found between cytological abnormalities and the HIV load and nadir and current CD4 + counts. CONCLUSIONS: The prevalence of anal cytological lesions is high in MSM, even in HIV-infected individuals treated with combined antiretroviral therapy. In these subjects, HSILs occur more frequently and at a younger age in comparison with HIV-uninfected counterparts. Specific diagnostic procedures should be implemented to manage individuals at increased risk for anal cancer with an abnormal anal Papanicolaou test. Cancer Cytopathol 2018;126:461-70.

KW - anal cancer

KW - anal cytology

KW - anal neoplasia

KW - anal Papanicolaou (Pap) test

KW - human immunodeficiency virus (HIV)

KW - human papillomavirus

KW - men who have sex with men

KW - sexually transmitted infection (STI)

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U2 - 10.1002/cncy.22003

DO - 10.1002/cncy.22003

M3 - Article

AN - SCOPUS:85046358778

VL - 126

SP - 461

EP - 470

JO - Cancer cytopathology

JF - Cancer cytopathology

SN - 1934-662X

IS - 7

ER -