2016 IANS International Guidelines for Practice Standards in the Detection of Anal Cancer Precursors

Hillman, Richard J.; Cuming, Tamzin; Darragh, Teresa M.; Nathan, Mayura; Berry-Lawthorn, Michael; Goldstone, Stephen E.; Law, Carmella; Palefsky, Joel M.; Barroso, Luis F.; Stier, Elizabeth A.; Bouchard, Céline; Almada, Justine; Jay, Naomi

doi:10.1097/lgt.0000000000000256

Cited by 142 publications

(170 citation statements)

References 22 publications

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“…Due to the increased incidence of non‐AIDS‐defining malignancies in PLWH compared to age‐matched controls, screening approaches for prevention or early diagnosis of anal mucosal dysplasia have been discussed for PLWH of both genders . National and international guidelines as well as recent studies recommend an annual proctologic examination for PLWH . High‐resolution anoscopy (HRA) also has been proposed as initial method of screening for PLWH .…”

Section: Introductionmentioning

confidence: 99%

Evaluation of anal carcinoma screening in male and female HIV patients at an interdisciplinary HIV therapy centre

Todorova

Schwierzeck

Turek

et al. 2019

Acad Dermatol Venereol

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Background Incidence of anal carcinoma is increased in people living with HIV (PLWH). Due to the improved life expectancy in PLWH, identifying appropriate prevention strategies for non‐AIDS‐defining cancer types such as anal carcinoma has become a priority in managing PLWH today. Objective We aimed to evaluate anal cytology assessment as screening tool for anal dysplasia and/or carcinoma in PLWH, regardless of gender or sexual orientation. Additionally, we investigated the correlation between cancer risk factors and abnormal screening results in our patient cohort. Methods People living with HIV from the Interdisciplinary HIV Centre of the University Hospital rechts der Isar in Munich, Germany (IZAR), were screened for anal carcinoma by single cytobrush examination and anal Papanicolaou (PAP) smear assessment from 2013 to 2015. Patients with abnormal PAP smear result were offered a follow‐up examination after 12 months. Differences between two groups were tested for statistical significance using Student's t‐test and Mann–Whitney U‐test, as appropriate. Results In total, 101 PLWH were included. 26.7% of subjects (n = 27) were PAP IIID, and 9.9% (n = 10) were PAP IVa. Seven female subjects had an abnormal finding at screening. Smoking was significantly associated with abnormal findings at screening (P = 0.005). In addition, our study found an association between sexually transmitted infections (STI) and anal dysplasia. Condylomata acuminata were increased in subjects with PAP IIID/PAP IVa (P = 0.045). Reactive syphilis serology was found to be significantly associated with abnormal screening results (P = 0.016), respectively. Conclusion Our results demonstrate that smoking and two common STIs, condylomata acuminata and syphilis, are risk factors associated with advanced anal intraepithelial neoplasia (AIN) stages in our PLWH cohort. While further analysis is needed to determine diagnostic guidelines concerning AIN in PLWH, these results suggest that interdisciplinary lifestyle prevention strategies are required to reduce the risk factors for AIN in PLWH in an outpatient setting.

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Section: Introductionmentioning

confidence: 99%

Evaluation of anal carcinoma screening in male and female HIV patients at an interdisciplinary HIV therapy centre

Todorova

Schwierzeck

Turek

et al. 2019

Acad Dermatol Venereol

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“…There are no randomized studies to establish the reliability and validity of anal cancer screening, or evidence of improved survival rates from anal cancer screening. 53 There also is no consensus as to who should be screened with DARE. 54,55 The sensitivity, specificity, negative predictive value, and quality-of-life metrics and costs associated with false-positive and false-negative DARE have not been established.…”

Section: Anal Cancermentioning

confidence: 99%

“…52 High-resolution anoscopy (HRA) is similar to cervical colposcopy, allowing for visualization of dysplastic lesions and the identification of suspicious lesions to biopsy. 53 Screening for anal cancer is currently based on cytological detection of HPV-induced abnormalities, followed by histological confirmation and treatment of the precursor lesion, high-grade anal intraepithelial neoplasia (AIN). 53 Although similarities exist between cervical and anal cancer screening, outcome research into anal cancer screening is lacking.…”

Section: Anal Cancermentioning

confidence: 99%

“…53 Screening for anal cancer is currently based on cytological detection of HPV-induced abnormalities, followed by histological confirmation and treatment of the precursor lesion, high-grade anal intraepithelial neoplasia (AIN). 53 Although similarities exist between cervical and anal cancer screening, outcome research into anal cancer screening is lacking. 54 The various techniques which are used to screen for anal cancer include digital anal rectal exam (DARE), anal Papinicolaou (Pap) test, and HRA.…”

Section: Anal Cancermentioning

confidence: 99%

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Cancer screening in women living with HIV infection

Aboulafia

2017

Womens Health (Lond Engl)

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The number of women living with HIV continues to increase. Thirty years into the AIDS epidemic, we now expect those with access to highly active antiretroviral to survive into their seventh decade of life or beyond. Increasingly, the focus of HIV care is evolving from preventing opportunistic infections and treating AIDS-defining malignancies to strategies that promote longevity. This holistic approach to care includes detection of malignancies that are associated with certain viral infections, with chronic inflammation, and with lifestyle choices. The decision to screen an HIV-infected women for cancer should include an appreciation of the individualized risk of cancer, her life expectancy, and an attempt to balance these concerns with the harms and benefits associated with specific cancer screening tests and their potential outcome. Here, we review cancer screening strategies for women living with HIV/AIDS with a focus on cancers of the lung, breast, cervix, anus, and liver.

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“…16,38 While some authors of scholarly manuscripts have advocated for combined cytology and molecular testing, no true consensus exists for criteria regarding which populations would most benefit, optimal periodicity of testing strategies, and preferred test types. [39][40][41] In this retrospective study of unsatisfactory anal cytology samples, with other HR-HPV genotypes was associated with higher risk for biopsy proven HSIL. 22 Among available screening modalities, exfoliative anal cytology testing and HR-HPV DNA testing are less expensive and more readily available than high resolution anoscopy (HRA) with biopsy, a modality that is considered by some to be a diagnostic standard but is not available in many healthcare delivery systems.…”

Section: Discussionmentioning

confidence: 72%

Unsatisfactory exfoliative anal cytology samples, 15‐year experience with histologic, cytologic, and molecular follow‐up

Khattab

McMeekin

Taege

et al. 2017

Diagnostic Cytopathology

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High risk patients with unsatisfactory anal cytology are not "negative". At least one-third proved to be concomitantly HR-HPV DNA positive with one-fifth showing subsequent cytologic squamous abnormalities and with more than 5% being diagnosed with a high grade intraepithelial lesion within two years. Prompt repeat cytology and/or HR-HPV DNA is recommended for high risk patients with non-diagnostic cytology.

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2016 IANS International Guidelines for Practice Standards in the Detection of Anal Cancer Precursors

Cited by 142 publications

References 22 publications

Evaluation of anal carcinoma screening in male and female HIV patients at an interdisciplinary HIV therapy centre

Evaluation of anal carcinoma screening in male and female HIV patients at an interdisciplinary HIV therapy centre

Cancer screening in women living with HIV infection

Unsatisfactory exfoliative anal cytology samples, 15‐year experience with histologic, cytologic, and molecular follow‐up

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