International Journal of STD & AIDS > Volume 18, Number 2 > Pp. 77-80

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Original research articles

The prevalence, and predictive value, of abnormal anal cytology to diagnose anal dysplasia in a population of HIV-positive men who have sex with men

R D Cranston, S D Hart, J A Gornbein, S L Hirschowitz, G Cortina and A A Moe

Department of General Internal Medicine, University of California, Los Angeles, CA, USA; Department of Pathology, University of California, Los Angeles, CA, USA; Department of Biomathematics, University of California, Los Angeles, CA, USA; Department of Pathology, University of California, Los Angeles, CA, USA; Department of Pathology, University of California, Los Angeles, CA, USA; Department of Infectious Disease, University of California, Los Angeles, CA, USA

Due to the increasing incidence of anal cancer in HIV-positive men who have sex with men, and the potential to detect and treat high-grade anal dysplasia – the putative anal cancer precursor – we have introduced an anal cytology screening service. Patients with abnormal anal cytology have follow-up high-resolution anoscopy (HRA) with biopsy of lesions clinically suspicious for high-grade dysplasia. In total, 244 men were screened and 235 (96%) of the samples were adequate for cytological interpretation using the Bethesda 2001 system. One hundred and sixty-four (67%) men had abnormal anal cytology, and 93 of them had follow-up HRA and anal biopsy. The positive predictive value for any anal cytological abnormality to predict any degree of anal dysplasia was 95.7±2.1%, and for any anal cytological abnormality to predict high-grade anal dysplasia was 55.9±5.1%. Abnormal anal cytology was highly predicative of anal dysplasia on biopsy.

Key Words: ANAL • DYSPLASIA • CYTOLOGY

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