Liquid-based anal cytology as a screening tool for prevention of anal cancer in at-risk populations: a single-center retrospective analysis on 111 patients
J. coloproctol. (Rio J., Impr.)
;
41(4): 419-424, Out.-Dec. 2021. tab
Article
in English
| LILACS
| ID: biblio-1356442
ABSTRACT
Objective:
Squamous cell carcinoma of the anus (SCCA) is associated with human papillomavirus (HPV) infection in almost 90% of the cases. Its incidence is alarmingly high among men who have sex with men (MSM) and continues to increase at an average rate of 2% per year. The objective of the present study is to evaluate the usefulness and performance of liquid-based anal cytology as a screening tool for prevention and early detection of SCCA in a cohort of at-risk men.Method:
We conducted a retrospective study including 111 MSM, aged between 22 and 62 years old, who underwent anal cytological screening with a liquid-based Pap test at our sexually transmitted diseases (STDs) clinic from January 2015 to March 2017.Results:
Out of 111 anal smears, 57 (51,4%) resulted negative, 42 (37,8%) abnormal, and 12 (10,8%) unsatisfactory for the cytological evaluation. Only patients with an abnormal cytology underwent anoscopy and subsequent biopsy. The histological results were as follows negative for squamous intraepithelial lesion (SIL) in 5 cases, low-grade SIL (L-SIL) in 21, high-grade SIL (H-SIL) in 5, SCCA in 1. Five patients had a normal anoscopy and biopsy was not taken.Conclusion:
Liquid-based cytology, reducing the "darkening factors" typical for the conventional smears, has a higher positive predictive value than the traditional technique. Moreover, a cytological diagnosis of atypical squamous cells of undetermined significance (ASC-US) or L-SILmay hide a severe dysplasia or even a carcinoma. Thus, all patients with an abnormal anal cytology at any grade should be considered for anoscopy. (AU)
Full text:
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Index:
LILACS (Americas)
Main subject:
Anus Neoplasms
/
Cytodiagnosis
/
Sexual and Gender Minorities
Type of study:
Diagnostic study
/
Etiology study
/
Observational study
/
Prognostic study
/
Risk factors
/
Screening study
Limits:
Adult
/
Humans
/
Male
Language:
English
Journal:
J. coloproctol. (Rio J., Impr.)
Journal subject:
Cirurgia
/
Doenas Retais
/
Doenas do Colo
/
Gastroenterology
/
Cirurgia
Year:
2021
Type:
Article
Affiliation country:
Italy
Institution/Affiliation country:
Cancer Prevention and Research Unit/IT
/
University of Florence/IT
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