Anal cytological lesions and HPV infection in individuals at increased risk for anal cancer

M. G. Dona, M. Benevolo, A. Latini, F. Rollo, M. Colafigli, M. Frasca, M. Zaccarelli, A. Giglio, D. Moretto, E. Pescarmona, A. Cristaudo, M. Giuliani

Research output: Contribution to journalArticle

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 /=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. (c) 2018 American Cancer Society.
Original languageEnglish
Pages (from-to)461-470
Number of pages10
JournalCancer cytopathology
Volume126
Issue number7
DOIs
Publication statusPublished - Jul 1 2018

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

Keywords

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

Cite this

Anal cytological lesions and HPV infection in individuals at increased risk for anal cancer. / Dona, M. G.; Benevolo, M.; Latini, A.; Rollo, F.; Colafigli, M.; Frasca, M.; Zaccarelli, M.; Giglio, A.; Moretto, D.; Pescarmona, E.; Cristaudo, A.; Giuliani, M.

In: Cancer cytopathology, Vol. 126, No. 7, 01.07.2018, p. 461-470.

Research output: Contribution to journalArticle

Dona, MG, Benevolo, M, Latini, A, Rollo, F, Colafigli, M, Frasca, M, Zaccarelli, M, Giglio, A, Moretto, D, Pescarmona, E, Cristaudo, A & Giuliani, M 2018, 'Anal cytological lesions and HPV infection in individuals at increased risk for anal cancer', Cancer cytopathology, vol. 126, no. 7, pp. 461-470. https://doi.org/10.1002/cncy.22003 [doi]
Dona, M. G. ; Benevolo, M. ; Latini, A. ; Rollo, F. ; Colafigli, M. ; Frasca, M. ; Zaccarelli, M. ; Giglio, A. ; Moretto, D. ; Pescarmona, E. ; Cristaudo, A. ; Giuliani, M. / Anal cytological lesions and HPV infection in individuals at increased risk for anal cancer. In: Cancer cytopathology. 2018 ; Vol. 126, No. 7. pp. 461-470.
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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 /=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. (c) 2018 American Cancer Society.",
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T1 - Anal cytological lesions and HPV infection in individuals at increased risk for anal cancer

AU - Dona, M. G.

AU - Benevolo, M.

AU - Latini, A.

AU - Rollo, F.

AU - Colafigli, M.

AU - Frasca, M.

AU - Zaccarelli, M.

AU - Giglio, A.

AU - Moretto, D.

AU - Pescarmona, E.

AU - Cristaudo, A.

AU - Giuliani, M.

N1 - LR: 20180425; CI: (c) 2018; JID: 101499453; OTO: NOTNLM; 2018/01/19 00:00 [received]; 2018/03/20 00:00 [revised]; 2018/03/30 00:00 [accepted]; 2018/04/26 06:00 [entrez]; 2018/04/26 06:00 [pubmed]; 2018/04/26 06:00 [medline]; aheadofprint

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 /=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. (c) 2018 American Cancer Society.

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 /=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. (c) 2018 American Cancer Society.

KW - anal Papanicolaou (Pap) test

KW - anal cancer

KW - anal cytology

KW - anal neoplasia

KW - human immunodeficiency virus (HIV)

KW - human papillomavirus

KW - men who have sex with men

KW - sexually transmitted infection (STI)

U2 - 10.1002/cncy.22003 [doi]

DO - 10.1002/cncy.22003 [doi]

M3 - Article

VL - 126

SP - 461

EP - 470

JO - Cancer cytopathology

JF - Cancer cytopathology

SN - 1934-662X

IS - 7

ER -