Anal study in immunocompetent women with human papillomavirus related lower genital tract pathology.
OBJECTIVE
To estimate the prevalence of anal dysplasia in immunocompetent women with cervical intraepithelial dysplasia.


METHODS
We did a prospective cohort study, in which we enrolled 166 women with gynecological pathology related to human papilloma virus (HPV) infection. All patients underwent an anal cytology and HPV detection. Statistical analysis with a 95% confidence interval was used for prevalence calculations. A Χ2 test and Fisher's exact one were used to determine differences between groups of qualitative variables. Differences between normally distributed and non-normally distributed groups in quantitative variables were accounted for using Student's t-test or Mann-Whitney's U test, respectively.


RESULTS
Out of the 166 patients studied, high risk HPV in the anal canal was detected in 107 (64.46%) cases. The most prevalent genotype observed was non 16/18 high risk HPV, present in 54 (50.47%) patients. There was no a significant association with smoking, use of condom, anal intercourse, or anal benign pathology. However, a significant correlation between the presence of high risk HPV in the anal canal and the antecedent of condylomas was observed (p=0.047) (CI95%: 1.00%-12.58%). Women with cervical intraepithelial neoplasia (CIN) grade 1 had a significantly increased presence of high risk HPV in the anal canal (p=0.044). Out of the 166 women, 6 (3.61%) had abnormal anal cytology results, and were referred to high-resolution anoscopy. Anal biopsy was performed in these six cases. In 2 patients the biopsy reported low-grade Anal Intraepithelial Neoplasia: 1.20% (0.15%-4.28%).


CONCLUSIONS
Women with cervical intraepithelial dysplasia have 1.20% prevalence of anal intraepithelial neoplasia, so that it does not seem necessary to screen this population.
Hospital General Universitario de Alicante, Alicante, Spain. Electronic address: conchi.don@gmail.com.
Concepción
C
Donaire
Hospital General Universitario de Elche, Alicante, Spain.
Marcos
M
Reillo
Hospital General Universitario de Alicante, Alicante, Spain.
Juan C
JC
Martínez-Escoriza
Hospital General Universitario de Alicante, Alicante, Spain.
José A
JA
López-Fernández
D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000473:pathology* / Q000821:virology; D001005:Anus Neoplasms; D005260:Female; D006801:Humans; D008875:Middle Aged; D027383:Papillomaviridae / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000473:pathology* / Q000821:virology; D011446:Prospective Studies; D012725:Sexual Behavior; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000821:virology; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000473:pathology* / Q000821:virology
Anal dysplasia; Cervical dysplasia; HPV types