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Anal HSIL and Screening in HIV-Infected Women
Clin Infect Dis; ePub 2016 Nov 9; Gaisa, et al
Implementation of universal anal cancer (AC) screening offered to all HIV-infected women substantially reduced the numbers of high-grade intraepithelial lesions (HSIL) that would have been missed by strictly adhering to existing AC screening guidelines, a recent study found. Data from women who underwent AC screening with anal cytology from April 2009 to July 2014 were analyzed with outcomes and risk factors for anal HSIL reported. Researchers found:
- 745 HIV-infected women were screened with anal cytology; 39% had abnormal anal cytology on initial screen and 15% on secondary screen.
- 208 women underwent high-resolution anoscopy (HRA) following abnormal anal cytology.
- HSIL was found in 26% and 18% of anal biopsies following initial and secondary screen; 1 woman had AC.
- Cigarette smoking more than doubled HSIL risk.
- Among women who underwent AC screening despite not meeting existing guideline criteria, 21% and 10%, respectively, were found to have HSIL on biopsy.
Citation:
Gaisa M, Ita-Nagy F, Sigel K, et al. High rates of anal HSIL in HIV-infected women who do not meet screening guidelines. [Published online ahead of print November 9, 2016]. Clin Infect Dis. doi:10.1093/cid/ciw729.