Recommendations Favoring Anal Cytology as a Method for Anal Cancer Screening: A Systematic Review

Abstract

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.

Anal cytology and high‐risk human papilloma virus testing in atypical squamous categories: Value of concurrent testing in management of high‐risk population

“…In conclusion, most authors concur that anal cytology is an essential screening modality 17 . Meanwhile, the value of integrating cytology with HR‐HPV has also been reported in some studies 15,18 .…”

“…In conclusion, most authors concur that anal cytology is an essential screening modality. 17 Meanwhile, the value of integrating cytology with HR-HPV has also been reported in some studies. 15,18 One recent study similarly finds that co-testing is best used in atypical and normal cytology results resulting in highest specificity and sensitivity.…”

The Diagnostic Value of p16/Ki67 Dual Immunostaining for Anal Intraepithelial Neoplasia: A Meta-Analysis

“…Current evidence suggests that anal cytology is more appropriate for anal cancer screening owing to low false positives, compared with high-risk HPV testing ( Clarke & Wentzensen, 2018 ). A systematic review involving eight society or institutional recommendations suggests that anal cytology is a method for anal cancer screening in high-risk population, including MSM ( Albuquerque et al, 2019 ). Our findings suggest that p16/Ki67 dual immunostaining might be an adjuvant and potential triage test for anal cytology in anal cancer screening ( Bossuyt et al, 2006 ).…”

Penggunaan Laser CO2 Pada Penderita Kondiloma Akuminata Perianal dan HIV

“…Flat topped papules yang muncul berupa makula sampai dengan adanya peninggian. (8,14,17) Pada kasus ini, KA terjadi adalah bentuk Kutil papular, yang sewarna jaringan, papul "dome shaped dengan predileksi pada daerah perianal.…”