A prospective study of anal cancer screening in HIV-positive and negative MSM

AIDS
Alice M SchofieldHenry C Kitchener

Abstract

The study sought to establish the feasibility and acceptability of anal screening among men MSM. Prospective cohort study. Sexual health clinics in tertiary care. Known HIV-positive and negative MSM who have anoreceptive intercourse. Anal screening with human papilloma virus (HPV) testing, liquid-based cytology and high-resolution anoscopy with biopsy of anoscopic abnormalities. Participants completed questionnaires at baseline and at 6 months. Anal HPV was highly prevalent in MSM (HIV-positive, 88% and HIV-negative, 78%). Despite the high prevalence of cytological abnormality in both HIV-positive (46.2%) and negative (35.0%) MSM, almost half of anal intraepithelial neoplasia (AIN) of all grades were associated with negative cytology. Anoscopically directed biopsies detected AIN3 or worse (AIN3+) in 14 of 203 (6.9%) of HIV-positive MSM and three of 81 (3.7%) HIV-negative MSM. The corresponding prevalence of AIN2+ was 26.6 and 20.9%, respectively. One case of AIN3 was detected at the second visit. Screening was considered to be highly acceptable by participants. The high prevalence of high-risk-HPV and frequency of false negative cytology in this study suggest that high-resolution anoscopy would have most clinical utility, as a ...Continue Reading

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Citations

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Methods Mentioned

BETA
biopsy
genotyping
biopsies

Clinical Trials Mentioned

ISRCTN69055668

Software Mentioned

ANCHOR
ANALOGY

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