Evaluation of anal cytology and dysplasia in women with a history of lower genital tract dysplasia and malignancy.
To compare the prevalence of abnormal anal cytology, high-risk anal HPV and biopsy proven anal dysplasia among women with a history of lower genital tract malignancy compared to those with dysplasia.



A prospective cohort study was performed from December 2012 to February 2014 at outpatient clinics at an academic medical center. Women with a history of high-grade cervical, vulvar, or vaginal dysplasia, or malignancy were recruited. Anal cytology and HPV genotyping were performed. All women with abnormal anal cytology were referred for high-resolution anoscopy and biopsy.



Sixty-seven women had a lower genital tract malignancy and 123 had a history of genital dysplasia. Average age in the malignancy group was 52.6years (range 27-86) versus 43.5years (range 21-81) in the dysplasia group (p<0.0002). Similar rates of anal dysplasia were seen in both groups, 12.99% (10 cases) in the malignancy group, versus 12.20% (15) in the dysplasia group (p=1.0). Six women in the malignancy group had anal intraepithelial neoplasia (AIN2+) compared to 2 in the dysplasia group (p=0.03).



We found high rates of abnormal anal cytology and HPV in women with lower genital tract dysplasia and malignancy. We also found high rates of anal dysplasia in both groups with a trend towards increased rate in those women with history of genital malignancy. Since precancerous anal lesions are detectable and treatable, anal cancer screening may be potentially useful in both of these higher risk groups.
Department of Obstetrics and Gynecology, Women & Infants Hospital, Alpert Medical School of Brown University, Providence, RI 02905, United States. Electronic address: bcronin@wihri.org.
Beth
B
Cronin
Department of Obstetrics and Gynecology, Women & Infants Hospital, Alpert Medical School of Brown University, Providence, RI 02905, United States.
Amy
A
Bregar
Program in Women's Oncology, Division of Research, Department of Obstetrics and Gynecology, Women & Infants Hospital, Alpert Medical School of Brown University, Providence, RI 02905, United States.
Christine
C
Luis
University Surgical Associates, Alpert Medical School of Brown University, Providence, RI 02905, United States.
Steven
S
Schechter
Program in Women's Oncology, Department of Obstetrics and Gynecology, Women & Infants Hospital, Alpert Medical School of Brown University, Providence, RI 02905, United States.
Paul
P
Disilvestro
Department of Pathology, Women & Infants Hospital, Alpert Medical School of Brown University, Providence, RI 02905, United States.
Latha
L
Pisharodi
Department of Pathology, Women & Infants Hospital, Alpert Medical School of Brown University, Providence, RI 02905, United States.
C James
CJ
Sung
Division of Research, Department of Obstetrics and Gynecology, Women & Infants Hospital, Alpert Medical School of Brown University, Providence, RI 02905, United States.
Christina
C
Raker
Department of Quantitative Health Sciences, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, MA 01605, United States.
Melissa
M
Clark
Program in Women's Oncology, Department of Obstetrics and Gynecology, Women & Infants Hospital, Alpert Medical School of Brown University, Providence, RI 02905, United States.
Katina
K
Robison
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000473:pathology* / Q000821:virology; D001005:Anus Neoplasms / Q000473:pathology / Q000821:virology; D015331:Cohort Studies; D005260:Female; D005831:Genital Diseases, Female / Q000473:pathology* / Q000821:virology; D005833:Genital Neoplasms, Female / Q000473:pathology / Q000821:virology; D006801:Humans; D008875:Middle Aged; D027383:Papillomaviridae / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000473:pathology* / Q000821:virology; D011446:Prospective Studies; D055815:Young Adult