Anal human papillomavirus infection and abnormal anal cytology in women with genital neoplasia

Park, Ina U.; Ogilvie, James W.; Anderson, Kristin E.; Li, Zhong Ze; Darrah, Lindsay; Madoff, Robert D.; Downs, Levi S.

doi:10.1016/j.ygyno.2009.05.008

Cited by 67 publications

(55 citation statements)

References 20 publications

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“…Controversial results were published concerning the association between anal cytology and anal HPV prevalence. A previous study reported a suspicious anal cytology in <10% of women with lower genital tract dysplasia, while positive anal HPV results were detected in >50% (24). In the present study, a significant association between the cytological results of the cervix and HPV detection in the cervix was observed, while there was no significant association between the anal cytology results and positive anal HPV detection.…”

Section: Discussioncontrasting

confidence: 52%

Prevalence of human papillomavirus infection of the anal canal in women: A prospective analysis of high-risk populations

et al. 2017

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Abstract. Infection with certain types of human papillomavirus (HPV) has been associated with the development of cervical and anal cancer. Worldwide, the incidence of anal cancer has increased markedly. The present study aimed to evaluate the prevalence of HPV infection of the uterine cervix and anal canal in human immunodeficiency virus (HIV)-and non-HIV-infected risk populations. Cervical and anal HPV swabs and cytology samples were collected from 287 patients at the University Hospital of Munich, Germany between 2011 and 2013. Patients were divided into HIV-negative controls (G1) and two risk groups, including HIV-negative patients with cytological abnormalities of the cervix (G2) and HIV-infected patients (G3). Data, including clinical parameters, were analysed. The risk groups had significantly more positive results for HPV in the anus (71.03 and 83.15% for G2 and G3, respectively), as compared with G1. The predominant HPV genotypes found in the anus were high-risk HPV genotypes, which were significantly correlated with concomittant cervical HPV findings. In the risk groups, a significant association between the cytological findings and HPV detection in the cervix was found, while the results of the anus revealed no significance. The results of the present study suggested that the prevalence of HPV infection in the anal canal of risk populations is high. Furthermore, patients with abnormal cervical cytology results and HIV-infected women, irrespective of their individual cervical findings, may have a risk of concomittant anal high-risk HPV infection. Based on the predominant HPV genotypes found in the study, HPV vaccination could reduce the incidence of anal cancer. Nevertheless, high-risk patients should be intensively screened for anal squamous intraepithelial abnormalities to avoid invasive cancer stages.

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Section: Discussioncontrasting

confidence: 52%

Prevalence of human papillomavirus infection of the anal canal in women: A prospective analysis of high-risk populations

et al. 2017

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“…In agreement with this observation, we found a 5.3-fold greater prevalence of anal HPV infection within our study group of "high-risk" women treated for CIN 2+ compared to the control group of "low-risk" women without any significant cervical pathology. Detection of HR HPV DNA in the anus represents potential risk for future malignant transformation, because the majority of anal cancers are caused by HPV infection [1,2,7,13]. The main risk factor for development of anal HPV infection is coincident presence of cervical HPV infection.…”

Section: Discussionmentioning

confidence: 99%

“…Since more than 90 % of anal cancers are caused by high-risk human papillomavirus (HR HPV) infection [9], possible reasons for the greater risk in women include history of cervical intraepithelial neoplasia (CIN) and cervical cancer [10][11][12]. The only two studies dealing with women with lower genital tract intraepithelial lesions or cancers which also looked at anal HPV showed 45 -51 % HPV prevalence in this group [13,14]. In contrast, a large study on the prevalence of anal HPV infection in a healthy population demonstrated just 13 % (178/1363) of cases with concurrent anal and cervical HPV infection [15].…”

mentioning

confidence: 99%

Impact of risk factors on prevalence of anal HPV infection in women with simultaneous cervical lesion

Sláma¹,

Sehnal²,

Dušek³

et al. 2015

neo

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The aim of our study was to determine the risk factors associated with anal HPV infection in HIV-negative women with high-grade cervical lesion. The study group included 172 "high-risk" women who underwent conization for high-grade cervical intraepithelial lesion or microinvasive cervical cancer (CIN 2+). The control group consisted of 100 "low-risk" women with non-neoplastic gynecologic diseases. All participants completed a questionnaire detailing medical history and sexual risk factors and were subjected to anal and cervical HPV genotyping. Concurrent cervical and anal HPV infections were detected in 42.4% (73/172) women of the study group, and in 8.0% (8/100) of women in the control group, respectively. The subgroup with concurrent HPV infections (n=73) dominated women with CIN 3 and microinvasive cancer and anal HPV 16 infections (n=53). Women with concurrent infections more frequently reported any type of sexual contact with the anus including non-penetrative anal sex (OR 2.62, p=0.008). Reporting >5 lifetime sexual partners (OR 2.43, p=0.041), smoking > 60 cigarettes per week (OR 2.33, p=0.048), and a history of penetrative anal intercourse (OR 3.87, p=0.002) were observed as the significant risk factors in women with multiple concurrent HPV infections. Our data support anal HPV testing and anal Pap smear screening in all women with severe cervical lesions caused by HPV 16 and a history of any sexual contact with the anus, heavy smoking and/or more than 5 lifetime sexual partners. Key words: anal cancer, cervical intraepithelial neoplasia, HPV, risk factorAnal cancer is an uncommon disease, but its incidence has grown during the last decades in most developed countries [1]. The population at the highest risk of developing anal cancer includes HIV-infected subjects, males who have sex with males and transplant recipients [2][3][4][5][6]. Despite this fact, a still significant proportion of anal cancers are detected in generally healthy and HIV-negative subjects. Moreover, anal cancers are more frequently detected in women than in men [7]. In the U.S., invasive anal squamous cell carcinoma rates increased among females by 1.7 % per year between 1973 and 2005 [1]. In 2012 there were an estimated 6230 new cases of anal cancer in the U.S., with 3980 (63.9 %) cases occurring in women and only 2250 (36.1 %) cases in men [8]. Similarly, in the Czech Republic the prevalence of anal cancer is constantly higher among women than in men. In 2010 there were 129 new cases of anal cancer, with 85 (65.9 %) cases in women and 44 (34.1 %) cases in men.This gender difference is not clearly explained. Since more than 90 % of anal cancers are caused by high-risk human papillomavirus (HR HPV) infection [9], possible reasons for the greater risk in women include history of cervical intraepithelial neoplasia (CIN) and cervical cancer [10][11][12]. The only two studies dealing with women with lower genital tract intraepithelial lesions or cancers which also looked at anal HPV showed 45 -51 % HPV prevalence in this group [13,14]. ...

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“…Anal intercourse has been proposed as an important risk factor in some studies. 21,22 Nevertheless, Park et al 23 did not find a significant association between HPV infection, abnormalities at anal cytology and anal sex practices. As a caveat, this was a small study with 92 women with only nine presenting abnormal anal cytology.…”

Section: Risk Factors Implicated In Anal Intraepithelial Neoplasiamentioning

confidence: 96%

“…10,21,25 It is suggested that women with vulvar lesions related to cervical alterations are at a greater risk of presenting abnormal anal cytology, when compared to women with isolated cervical alterations. 23 HIV-infected women have a higher frequency of abnormal anal cytology in relation to seronegative women, with abnormal cytology in up to 26% of cases. Hessol et al 26 compared 470 HIV-infected women to 185 HIV-negative women.…”

Section: Risk Factors Implicated In Anal Intraepithelial Neoplasiamentioning

confidence: 96%

HPV infection and intraepithelial lesions from the anal region: how to diagnose?

Carvalho¹,

Ferreira²,

Bueno³

2011

Braz J Infect Dis

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In the last years, the prevalence of HPV infection in the anal region has increased, especially in some groups like homosexual and HIV-positive people. Since this infection can be associated with the development of squamous anal cancer due to its progression from HPV infection to anal intraepithelial neoplasia (AIN) and finally to cancer, the screening and evaluation of these conditions are important. Anal cytology and high resolution anoscopy are good methods that are available and can be used. Although useful, these methods should be performed correctly and not indiscriminately in all patients. Patients for whom anal cytology screening is recommended are: HIV-infected patients, homosexuals, women who present with high-grade vulvar squamous intraepithelial neoplasia, vulvar cancer or cervical cancer. An abnormal anal cytology should be further evaluated with high resolution anoscopy. Keywords: anal canal; papillomavirus infections; cell biology; carcinoma in situ.identify these pre-invasive lesions is being questioned. Such questions relate to the groups to be screened and the best way to implement it such screening. The purpose of this study was to review the literature about the use of anal cytology and anoscopy to screening and evaluation of anal intraepithelial neoplasia. ANAL CYTOLOGYAnal cytology is a noninvasive method of screening, which is performed primarily by anal secretion collection through a brush (Dacron swab) introduced into the anal canal and removed with gentle rotation movements. It is indicated to avoid anal sex and douching in the day before the procedure, since these practices can decrease cellular recovery. Special caution should be taken for not touching anal canal warts and rectum walls with the brush to avoid any fecal contamination.

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Anal human papillomavirus infection and abnormal anal cytology in women with genital neoplasia

Cited by 67 publications

References 20 publications

Prevalence of human papillomavirus infection of the anal canal in women: A prospective analysis of high-risk populations

Prevalence of human papillomavirus infection of the anal canal in women: A prospective analysis of high-risk populations

Impact of risk factors on prevalence of anal HPV infection in women with simultaneous cervical lesion

HPV infection and intraepithelial lesions from the anal region: how to diagnose?

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