The Role of Cytology (Pap Tests) and Human Papillomavirus Testing in Anal Cancer Screening

Published: September 27, 2010

In the current study, investigators assessed anal oncogenic human papillomavirus (HPV) and anal cytology as screening tests for detecting high-grade intraepithelial neoplasia (AIN 2+), since this is an immediate precursor to anal cancer.

A cross-sectional study of 401 HIV-positive men who have sex with men was performed, with the endpoint being histologically confirmed AIN 2+ obtained by high-resolution anoscopy (HRA). Two pathologists assigned random numbers and independently assessed the cytology and biopsy specimens.

Concomitant anal cytology, anal HPV testing, and HRA with directed biopsies were conducted without knowledge of the results of each intervention. The main outcome measures were the sensitivity, specificity, negative predictive value, and positive predictive value of anal cytology and oncogenic HPV for AIN 2+ detection.

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