title: The changing picture of high-grade anal intraepithelial neoplasia in men who have sex with men: the effects of 10 years of experience performing high-resolution anoscopy.
abstract: BACKGROUND
  Ten years ago, we published findings from anal dysplasia screening in a metropolitan surgical practice where the majority of men who have sex with men had biopsy-proven high-grade anal intraepithelial neoplasia.
  
  
  OBJECTIVE
  This study aimed to determine the effect of 10 years of experience in anal dysplasia screening on the prevalence of high-grade anal intraepithelial neoplasia.
  
  
  METHODS
  A retrospective chart review was performed of all anal cytology results of 1189 men who have sex with men screened in a 1-year period, with subsequent high-resolution anoscopy and biopsy as necessary.
  
  
  METHODS
  The patients studied were men who have sex with men.
  
  
  METHODS
  The main outcome measure was biopsy-proven high-grade anal intraepithelial neoplasia.
  
  
  RESULTS
  : There were 315 (37.2%) biopsy-verified instances of high-grade anal intraepithelial neoplasia. Regression analysis determined that age, HIV status, infection by high-risk human papillomavirus, and abnormal cytology results were significant predictors of high-grade anal intraepithelial neoplasia. In a 1-year period, the number of men who have sex with men screened was nearly 7 times greater than in the 2-year period studied 10 years earlier.
  
  
  CONCLUSIONS
  We did not separately analyze patients who had previously been treated for high-grade anal intraepithelial neoplasia.
  
  
  CONCLUSIONS
  Severity of cytology and infection with high-risk human papillomavirus are the most significant predictors of high-grade anal intraepithelial neoplasia, underscoring the importance of anal dysplasia screening. Our ability to identify high-grade anal intraepithelial neoplasia has improved with 10 years of experience performing high-resolution anoscopy.
authors: Department of Preventive Medicine, Mount Sinai School of Medicine, New York, New York, USA. segmd@prodigy.net
authors: Kristin A
authors: KA
authors: Swedish
authors: Eric Q
authors: EQ
authors: Lee
authors: Stephen E
authors: SE
authors: Goldstone
mesh_terms: D000328:Adult; D000368:Aged; D001005:Anus Neoplasms / Q000453:epidemiology* / Q000473:pathology*; D001706:Biopsy; D002278:Carcinoma in Situ / Q000453:epidemiology* / Q000473:pathology*; D055088:Early Detection of Cancer; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D006679:HIV Seropositivity; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D055815:Young Adult