The prevalence, and predictive value, of abnormal anal cytology to diagnose anal dysplasia in a population of HIV-positive men who have sex with men.
Due to the increasing incidence of anal cancer in HIV-positive men who have sex with men, and the potential to detect and treat high-grade anal dysplasia--the putative anal cancer precursor--we have introduced an anal cytology screening service. Patients with abnormal anal cytology have follow-up high-resolution anoscopy (HRA) with biopsy of lesions clinically suspicious for high-grade dysplasia. In total, 244 men were screened and 235 (96%) of the samples were adequate for cytological interpretation using the Bethesda 2001 system. One hundred and sixty-four (67%) men had abnormal anal cytology, and 93 of them had follow-up HRA and anal biopsy. The positive predictive value for any anal cytological abnormality to predict any degree of anal dysplasia was 95.7+/-2.1%, and for any anal cytological abnormality to predict high-grade anal dysplasia was 55.9+/-5.1%. Abnormal anal cytology was highly predicative of anal dysplasia on biopsy.
Cranston
R D
RD
Department of General Internal Medicine, University of California, Los Angeles, CA 90035, USA. rcranston@mednet.ucla.edu
Hart
S D
SD
Gornbein
J A
JA
Hirschowitz
S L
SL
Cortina
G
G
Moe
A A
AA
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000453:epidemiology; D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000473:pathology*; D001005:Anus Neoplasms / Q000175:diagnosis / Q000453:epidemiology; D001706:Biopsy; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000453:epidemiology; D003584:Cytological Techniques; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence