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Anal cytology screening for lesions among HIV-positive patients.

Anal carcinoma is relatively rare although its incidence is increasing, particularly among HIV-positive men who have sex with men. Anal carcinoma shares many similarities with cervical cancer, and based on the cervical cancer screening programme, many experts have suggested that routine anal cytology screening be performed on high-risk individuals to detect and remove pre-cancerous anal lesions. This study describes a routine anal cytology screening programme in an urban HIV-positive population in the US to determine risk factors for abnormal anal cytology and whether an association exists between abnormal cytology and histology.

49% of the 560 clinic patients were screened for two years, of whom 32% were women. 28% had abnormal anal cytology, and they were also more likely to have anal disease on perianal visual inspection and a history of genital warts. They were also more likely to be caucasian, homosexual or bisexual and have a lower CD4+ count. Routine anal cytology screening is a feasible tool to incorporate into routine HIV care. Cytological abnormalities were found in patients without obvious risk factors, suggesting that all HIV-positive patients should have anal cancer screening. The follow-up for abnormal cytology represents the most difficult aspect of the programme, including getting patients to come for anoscopy. (1)

(1.) Scott H, Khoury R, Moore BA, et al. Routine anal cytology screening for anal squamous intraepithelial lesions in an urban HIV clinic. Sexually Transmitted Diseases 2008;35(2):197-202.
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Title Annotation:ROUND UP: Reproductive cancers
Publication:Reproductive Health Matters
Article Type:Brief article
Geographic Code:1USA
Date:Nov 1, 2008
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