Anal cancer screening in a high-risk behavior group: A local picture / Rastreamento de câncer anal em um grupo de comportamento de alto risco: uma imagem local

ABSTRACT Study objectives To perform anal lesion and anal cancer screening in men living with HIV/AIDS. Methods This is a descriptive, observational, cross-sectional study. Data were obtained from the Specialized Assistance Service (SAE) in Divinópolis, Minas Gerais. A sociodemographic, epidemiological, and sexual behavior questionnaire was applied; material was collected for cytology, high-resolution anoscopy (AAR) was performed, and an acceptability questionnaire applied. Main results Of the 50 men living with HIV/AIDS invited to participate in this study, 6% were excluded because they were illiterate, 40% refused to participate, and 54% participated in the survey. Among these, all answered the self-administered questionnaire. However, ten (37.0%) underwent proctological examination and anal cytology. Of these, two did not respond to the acceptability questionnaire. No anal lesions were identified during AAR and no biopsy was required. A 10% change in anal cytology was found. Conclusions Through the study it was possible to construct a flow of referrals from the SAE to the UFSJ Coloproctology outpatient clinic. Moreover, the existence of internal stigmas on the part of the participants regarding the proctological examination and the lack of information about anal cancer screening are challenges to be overcome.

RESUMO Objetivos do estudo Realizar o rastreamento de lesões anais e câncer anal em homens vivendo com HIV/AIDS. Métodos Trata-se de estudo descritivo observacional transversal, cujos dados foram obtidos no Serviço de Assistência Especializada (SAE) em Divinópolis, Minas Gerais. Foi aplicado questionário sociodemográfico, epidemiológico e de comportamento sexual; realizada coleta de material para citologia, Anuscopia de Alta Resolução (AAR) e aplicado questionário de aceitabilidade do exame. Principais resultados Dos 50 homens vivendo com HIV/AIDS convidados a participar do presente estudo, 6% foram excluídos por serem analfabetos, 40% se recusaram a participar e 54% participaram da pesquisa. Entre estes, todos responderam o questionário autoaplicado. Entretanto, 10 (37.0%) realizaram o exame proctológico e a citologia anal. Desses, dois não responderam ao questionário de aceitabilidade. Não foram identificadas lesões anais durante a AAR, não sendo necessária a realização de biópsia. Foi encontrado 10% de alteração à citologia anal. Conclusões Por meio do estudo foi possível construir um fluxo de encaminhamentos do SAE para o ambulatório de Coloproctologia da UFSJ. Ademais, a existência de estigmas internos por parte dos participantes no que concerne à realização do exame proctológico e a falta de informação a respeito do rastreamento do câncer anal são desafios a serem vencidos.

The Value of HPV detection as a Follow-up Modality after Treatment of Cervical Precanceous Lesions / 대한부인종양콜포스코피학회잡지

OBJECTIVES: After LEEP conization of cervical precancerous lesions, cytologic follow-up and colposcopy is frequently unsatisfactory. This study was performed to investigate the relationship between the presence of human papillomavirus (HPV) and abnormal follow-up results. METHODS: Between March 1995 and Feburary 1999, 98 patients treated by LEEP for cervical dysplasia and CIS were included. All patient had initially done HPV testing by Hybrid Capture System (Digene Co., U.S.A.). Patients were followed up with PAP, colposcopy and HPV test. RESULTS: After mean follow-up 10.9-month follow-up, 9 patients (9.2%) had the abnormal cytology (>ASCUS). After treatment, there were 2 abnormal cytologic follow-up cases (13.3%) in the groups of koilocytosis and CIN I in initial tissue pathology, 7 abnormal follow-up cases (8.4%) in groups of CIN II/III and CIS. There was no significant difference between the recurrence rates of these two group (P=0.27). The presence of high-risk HPV DNA after LEEP was done in 26 cases. Of the HPV-positive follow-up cases, 4 patients (50%) had abnormal cytologic results. But none had abnormal cytology in HPV-negative patients. CONCLUSION: Participants with positive follow-up HPV test have a higher recurrence rate than those with negative HPV test. Our study suggests the value of supplementary HPV DNA testing during follow-up of patients treated for cervical precancerous lesions.

Clinical Efficacy of Human Papilloma Virus DNA Test Using Hybrid Capture System in Health Screening of Normal Women / 대한부인종양콜포스코피학회잡지

Cervical cancer and its precursors are caused principally, if not exclusively, by HPV infection and HPV DNA is found in more than 90% of cervical cancers. Cervical cytology is limited by its false negativity and this may be supplimented by other adjunctive test such as HPV test. It is therefore important to explore the use of HPV DNA detection as a primary or supplementary screening method and to determine whether HPV typing can be used as a predictor of a lesion's clinical behavior. Cervical cytology and Hybrid Capture test for HPV detection were performed in 450 asymtomatic wornen visited Health Care Center in Kangnam St. Mary's Hospital,and none of whom was believed to have current cervical disease. The Papanicolaou cytology results were classified by The Bethesda System : 333(74.%) women were classified to within normal limit, 19(4.2%) benign reactive change, 38(8.4%) ASCUS, 59(13%) low grade SIL, and only one woman high grade SIL. Twenty five of 450(5.6%) women showed HPV infection by Hybid Capture test. Among 98 wornen with abnormal Papanicolaou cytology, 16(16.3%) women showed HPV DNA positivity. (continue)