Self-collected versus clinician-collected anal cytology specimens to diagnose anal intraepithelial neoplasia in HIV-positive men.
BACKGROUND
Anal intraepithelial neoplasia (AIN) is common in men who have sex with men (MSM) and may be diagnosed by anal cytology screening.


METHODS
One hundred two MSM with clinician-collected anal cytology and histopathology specimens were assessed from a cohort study of AIN at the University of California at San Francisco. The men were given a cytology self-collection kit with written instructions for use and requested to collect the sample 1 month after the clinic visit.


RESULTS
Ninety-one percent of self-collected and 99% of clinician-collected anal cytology samples were adequate for interpretation. The sensitivity of abnormal anal cytology to detect AIN by histology was 68% in self-collected samples and 70% in clinician-collected samples, and the sensitivity to detect AIN 2 or AIN 3 was 71% and 74%, respectively. Cytologic results did not differ by grade between self-collected and clinician-collected samples. Among MSM diagnosed with AIN 2 or 3 by biopsy, 33% of self-collected and 39% of clinician-collected cytology samples were high-grade. The sensitivity of both self-collected and clinician-collected samples to detect AIN 2 or 3 was higher among HIV-positive MSM than among HIV-negative MSM.


CONCLUSIONS
MSM with biopsy-proven AIN can self-collect anal cytology samples with sensitivity comparable with that of experienced clinicians. This may facilitate screening for AIN.
Cranston
Ross D
RD
Department of Medicine, University of California at San Francisco, 94143, USA.
Darragh
Teresa M
TM
Holly
Elizabeth A
EA
Jay
Naomi
N
Berry
J Michael
JM
Da Costa
Maria
M
Efird
Jimmy T
JT
Palefsky
Joel M
JM
D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000473:pathology*; D001005:Anus Neoplasms / Q000175:diagnosis* / Q000209:etiology* / Q000473:pathology; D001706:Biopsy; D002278:Carcinoma in Situ / Q000175:diagnosis* / Q000209:etiology* / Q000473:pathology; D015331:Cohort Studies; D006679:HIV Seropositivity / Q000150:complications*; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D011933:Reagent Kits, Diagnostic; D012495:San Francisco; D012648:Self Care; D012680:Sensitivity and Specificity
D011933:Reagent Kits, Diagnostic