title: Description of a pilot anal pap smear screening program among individuals attending a Veteran's Affairs HIV clinic.
abstract: Despite the higher risk of anal cancer among HIV-infected individuals currently there are no national or international guidelines for anal dysplasia screening. We assessed acceptance and feasibility of screening for anal intraepithelial neoplasia (AIN), the rate of abnormalities, and relationship between the presence of AIN and a history of receptive anal intercourse. Eighty-two percent of HIV-patients approached during routine clinic visit agreed to participate in the study with anal Pap smear collection; 53% had abnormal cytology results and among those undergoing high-resolution anoscopy with biopsy, 55% had high-grade AIN, including 2 cases of carcinoma in situ. Anal cytology was well accepted and it was feasible to be incorporated into HIV primary care practice. Abnormal cytology was not significantly associated with history of anal intercourse (p = 0.767). The high rate of abnormal results reinforces the need for further evaluation of the role of systematic anal Pap smear screening for HIV patients.
authors.affiliation: Division of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine , Miami, Florida 33136, USA. IRosa-Cunha@med.miami.edu
authors.forename: Isabella
authors.initials: I
authors.lastname: Rosa-Cunha
authors.forename: Vincent A
authors.initials: VA
authors.lastname: Degennaro
authors.forename: Rene
authors.initials: R
authors.lastname: Hartmann
authors.forename: Clara
authors.initials: C
authors.lastname: Milikowski
authors.forename: Andres
authors.initials: A
authors.lastname: Irizarry
authors.forename: Brenda
authors.initials: B
authors.lastname: Heitman
authors.forename: Orlando
authors.initials: O
authors.lastname: Gómez-Marín
authors.forename: Gordon M
authors.initials: GM
authors.lastname: Dickinson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities / Q000458:organization & administration; D001003:Anal Canal / Q000473:pathology* / Q000821:virology; D023241:Antiretroviral Therapy, Highly Active; D001005:Anus Neoplasms / Q000175:diagnosis / Q000209:etiology / Q000473:pathology*; D001706:Biopsy; D002278:Carcinoma in Situ / Q000175:diagnosis / Q000209:etiology / Q000473:pathology*; D005431:Florida / Q000453:epidemiology; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D010865:Pilot Projects; D012725:Sexual Behavior; D012959:Socioeconomic Factors; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000706:statistics & numerical data