Detection of oncogenic human papillomavirus impacts anal screening guidelines in men who have sex with men

Diseases of the Colon and Rectum
Stephen E Goldstone, Erin Moshier

Abstract

It has been shown that testing for oncogenic human papillomavirus (HPV+) improves the sensitivity of cytologic diagnosis of atypical cells of undetermined significance in the cervix and anus, reducing the number of patients requiring colposcopy or high-resolution anoscopy. Some recommend that men who have sex with men with any abnormal cytology undergo high-resolution anoscopy. We endeavored to determine whether HPV testing could predict future high-grade dysplasia (high-grade squamous intraepithelial lesions) and modify screening internals. This investigation was conducted via a retrospective chart review of subjects with atypical cells of undetermined significance anal cytology, high-resolution anoscopy, and HPV testing. Records were abstracted for prior and subsequent screenings. Four hundred men who have sex with men (285 HIV-) underwent 2224 screenings. Of 224 subjects monitored for >2 years, the hazard ratio for developing high-grade dysplasia was 77% less for men who have sex with men who never had oncogenic HPV (HPV-) vs those who stayed HPV+ (P < .013). The hazard ratio for high-grade dysplasia in those who were HPV- vs those who became HPV- was not different. Risk of high-grade dysplasia was 28% within 6 months of bec...Continue Reading

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Citations

Sep 7, 2012·Sexual Health·Teresa M Darragh, Barbara Winkler
Sep 10, 2011·Diseases of the Colon and Rectum·Robert N GoldstoneStephen E Goldstone
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