title: Self-collected versus clinician-collected anal cytology specimens to diagnose anal intraepithelial neoplasia in HIV-positive men.
abstract: 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.
authors.affiliation: Department of Medicine, University of California at San Francisco, 94143, USA.
authors.forename: Ross D
authors.initials: RD
authors.lastname: Cranston
authors.forename: Teresa M
authors.initials: TM
authors.lastname: Darragh
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Holly
authors.forename: Naomi
authors.initials: N
authors.lastname: Jay
authors.forename: J Michael
authors.initials: JM
authors.lastname: Berry
authors.forename: Maria
authors.initials: M
authors.lastname: Da Costa
authors.forename: Jimmy T
authors.initials: JT
authors.lastname: Efird
authors.forename: Joel M
authors.initials: JM
authors.lastname: Palefsky
mesh_terms: 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
chemical_list: D011933:Reagent Kits, Diagnostic