title: Anal Pap smears: Should we be doing them?
abstract: OBJECTIVE
  To identify the need to perform anal Papanicolau (Pap) smears for diagnosing histologic changes associated with human papilloma virus (HPV) infection in order to provide early intervention for the prevention of anal cancer. To offer the primary care provider information, based on evidence-based research, about identifying the high-risk patient using risk factors, instructions on performing the anal Pap smear, interpreting the results, and initiating treatment interventions and/or referrals for care. Additionally, the possibility of an HPV vaccine for men will be discussed.
  
  
  METHODS
  Evidence-based literature, theoretical framework, and peer-reviewed articles.
  
  
  CONCLUSIONS
  Performing anal Pap smears is a valuable tool to detect cytologic changes associated with some strains of HPV infection. For persons participating in receptive anal intercourse, this diagnostic procedure provides the opportunity for early detection to guide appropriate follow-up and interventions.
  
  
  CONCLUSIONS
  Appropriate screening can be incorporated easily into a primary care practice. High-risk groups that would benefit from this screening include men who have sex with men, HIV-infected men and women, immunocompromised men and women, women with a history of cervical or vulvar cancer (or high-grade cervical lesions), and women participating in receptive anal intercourse.
authors.affiliation: Western Carolina University, School of Nursing, MS (N) Program, Cullowhee, North Carolina 28715, USA.
authors.forename: Kimberley
authors.initials: K
authors.lastname: Lindsey
authors.forename: Claire
authors.initials: C
authors.lastname: DeCristofaro
authors.forename: Janet
authors.initials: J
authors.lastname: James
mesh_terms: D001003:Anal Canal / Q000821:virology*; D001005:Anus Neoplasms / Q000175:diagnosis* / Q000517:prevention & control / Q000821:virology; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D065006:Papanicolaou Test; D030361:Papillomavirus Infections / Q000150:complications / Q000175:diagnosis*; D012307:Risk Factors; D012309:Risk-Taking; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control / Q000821:virology; D014626:Vaginal Smears