title: Anal Cytology and Human Papillomavirus Genotyping in Women With a History of Lower Genital Tract Neoplasia Compared With Low-Risk Women.
abstract: OBJECTIVE
  To compare the prevalence of abnormal anal cytology and high-risk human papillomavirus (HPV) among women with a history of HPV-related genital neoplasia with women without a history of HPV-related genital neoplasia.
  
  
  METHODS
  A cross-sectional cohort study was performed from December 2012 to February 2014. Women were recruited from outpatient clinics at an academic medical center. Women with a history of high-grade cervical, vulvar, or vaginal cytology, dysplasia, or cancer were considered the high-risk group. Women with no history of high-grade anogenital dysplasia or cancer were considered the low-risk group. Human immunodeficiency virus-positive women were excluded. Anal cytology and HPV genotyping were performed. Women with abnormal anal cytology were referred for high-resolution anoscopy.
  
  
  RESULTS
  There were 190 women in the high-risk group and 83 in the low-risk group. The high-risk group was slightly older: 57 years compared with 47 years (P=.045); 21.7% of low-risk women had abnormal anal cytology compared with 41.2% of high-risk women (P=.006). High-risk HPV was detected in the anal canal of 1.2% of the low-risk group compared with 20.8% of the high-risk group (P<.001). Among women who underwent anoscopy, no anal dysplasia was detected in the low-risk group, whereas 13.4% in the high-risk group had anal dysplasia with 4.2% having anal intraepithelial neoplasia 2 or greater (P<.001).
  
  
  CONCLUSIONS
  Human immunodeficiency virus-negative women with a history of lower genital tract neoplasia are more likely to have positive anal cytology, anal high-risk HPV, and anal intraepithelial neoplasia. Anal cancer screening should be considered for these high-risk women.
  
  
  METHODS
  II.
authors.affiliation: Women & Infants Hospital, the Department of Pathology, the Warren Alpert Medical School of Brown University, the Program in Women's Oncology, University Surgical Associates, and the Division of Research and Department of Epidemiology, Brown University, School of Public Health, Providence, Rhode Island.
authors.forename: Katina
authors.initials: K
authors.lastname: Robison
authors.forename: Beth
authors.initials: B
authors.lastname: Cronin
authors.forename: Amy
authors.initials: A
authors.lastname: Bregar
authors.forename: Christine
authors.initials: C
authors.lastname: Luis
authors.forename: Paul
authors.initials: P
authors.lastname: DiSilvestro
authors.forename: Steven
authors.initials: S
authors.lastname: Schechter
authors.forename: Latha
authors.initials: L
authors.lastname: Pisharodi
authors.forename: Christina
authors.initials: C
authors.lastname: Raker
authors.forename: Melissa
authors.initials: M
authors.lastname: Clark
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000473:pathology / Q000821:virology*; D001005:Anus Neoplasms / Q000175:diagnosis / Q000209:etiology* / Q000821:virology; D016022:Case-Control Studies; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D005833:Genital Neoplasms, Female / Q000150:complications*; D060005:Genotyping Techniques; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D016017:Odds Ratio; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000150:complications / Q000175:diagnosis* / Q000821:virology; D012307:Risk Factors; D055815:Young Adult
chemical_list: D004279:DNA, Viral