title: Anal intraepithelial neoplasia in a sexually transmitted diseases outpatient clinic: correlation with cytological screening.
abstract: BACKGROUND
  High-grade anal intraepithelial neoplasia (AIN) is currently considered a precursor of anal cancer. The population most susceptible to AIN is men who have sex with men (MSM), especially if they are infected by HIV.
  
  
  OBJECTIVE
  We analysed the population diagnosed with AIN and evaluated anal cytology as a method of screening the at-risk population.
  
  
  METHODS
  We undertook a retrospective review of patients diagnosed with AIN by means of a surgical biopsy between 2008 and 2010. We analysed the risk factors of the population affected and the degree of agreement with the cytology performed previously.
  
  
  RESULTS
  During the study period 41 patients were diagnosed with AIN and seven with anal canal carcinoma in situ; 77% were men, most MSM. A history of receptive anal intercourse was found in 81% of the patients and in 71% there was an association with anogenital warts; 32 patients were HIV-positive, most of them men. Of the patients with anal dysplasia of any type in the cytology, 90% had some grade of AIN or carcinoma in situ in the later biopsy. The degree of agreement between the cytology and the biopsy was 94% in the high-grade dysplasias and 50% in the low-grade dysplasias.
  
  
  CONCLUSIONS
  Anal cytology in at-risk populations has a high degree of agreement with the biopsy when performed surgically, though less in low-grade dysplasias, which must always be studied. More studies evaluating the degree of progression of AIN to anal cancer are necessary.
authors: Department of Dermatology, Hospital Costa del Sol, Marbella, Spain.
authors: J B
authors: JB
authors: Repiso Jiménez
authors: M
authors: M
authors: Frieyro-Elicegui
authors: L
authors: L
authors: Padilla-España
authors: F
authors: F
authors: Palma-Carazo
authors: J
authors: J
authors: de la Torre Lima
authors: F
authors: F
authors: Rivas-Ruiz
mesh_terms: D000554:Ambulatory Care Facilities; D001005:Anus Neoplasms / Q000175:diagnosis* / Q000473:pathology; D001706:Biopsy; D002278:Carcinoma in Situ / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male