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Background: Ten years ago, we published findings from anal dysplasia screening in a metropolitan surgical practice where the majority of men who have sex with men had biopsy-proven high-grade anal intraepithelial neoplasia.
Objective: This study aimed to determine the effect of 10 years of experience in anal dysplasia screening on the prevalence of high-grade anal intraepithelial neoplasia.
Design: A retrospective chart review was performed of all anal cytology results of 1189 men who have sex with men screened in a 1-year period, with subsequent high-resolution anoscopy and biopsy as necessary.
Patients: The patients studied were men who have sex with men.
Main Outcome Measure: The main outcome measure was biopsy-proven high-grade anal intraepithelial neoplasia.
Results: : There were 315 (37.2%) biopsy-verified instances of high-grade anal intraepithelial neoplasia. Regression analysis determined that age, HIV status, infection by high-risk human papillomavirus, and abnormal cytology results were significant predictors of high-grade anal intraepithelial neoplasia. In a 1-year period, the number of men who have sex with men screened was nearly 7 times greater than in the 2-year period studied 10 years earlier.
Limitations: We did not separately analyze patients who had previously been treated for high-grade anal intraepithelial neoplasia.
Conclusions: Severity of cytology and infection with high-risk human papillomavirus are the most significant predictors of high-grade anal intraepithelial neoplasia, underscoring the importance of anal dysplasia screening. Our ability to identify high-grade anal intraepithelial neoplasia has improved with 10 years of experience performing high-resolution anoscopy.
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| http://dx.doi.org/10.1097/DCR.0b013e31821d6cb9 | DOI Listing |
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