The changing picture of high-grade anal intraepithelial neoplasia in men who have sex with men

The effects of 10 years of experience performing high-resolution anoscopy

Kristin A. Swedish, Eric Q. Lee, Stephen E. Goldstone

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

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 highresolution 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.

Original languageEnglish (US)
Pages (from-to)1003-1007
Number of pages5
JournalDiseases of the Colon and Rectum
Volume54
Issue number8
DOIs
StatePublished - Aug 2011
Externally publishedYes

Fingerprint

Neoplasms
Cell Biology
Biopsy
HIV Infections
Regression Analysis
Outcome Assessment (Health Care)
Infection

Keywords

  • Anal cancer
  • Anal neoplasia
  • Human papillomavirus
  • Men who have sex with men

ASJC Scopus subject areas

  • Gastroenterology

Cite this

@article{17b7e1dbe9474e7a902eeef355070025,
title = "The changing picture of high-grade anal intraepithelial neoplasia in men who have sex with men: The effects of 10 years of experience performing high-resolution anoscopy",
abstract = "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 highresolution 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.",
keywords = "Anal cancer, Anal neoplasia, Human papillomavirus, Men who have sex with men",
author = "Swedish, {Kristin A.} and Lee, {Eric Q.} and Goldstone, {Stephen E.}",
year = "2011",
month = "8",
doi = "10.1097/DCR.0b013e31821d6cb9",
language = "English (US)",
volume = "54",
pages = "1003--1007",
journal = "Diseases of the Colon and Rectum",
issn = "0012-3706",
publisher = "Lippincott Williams and Wilkins",
number = "8",

}

TY - JOUR

T1 - The changing picture of high-grade anal intraepithelial neoplasia in men who have sex with men

T2 - The effects of 10 years of experience performing high-resolution anoscopy

AU - Swedish, Kristin A.

AU - Lee, Eric Q.

AU - Goldstone, Stephen E.

PY - 2011/8

Y1 - 2011/8

N2 - 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 highresolution 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.

AB - 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 highresolution 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.

KW - Anal cancer

KW - Anal neoplasia

KW - Human papillomavirus

KW - Men who have sex with men

UR - http://www.scopus.com/inward/record.url?scp=80052729638&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80052729638&partnerID=8YFLogxK

U2 - 10.1097/DCR.0b013e31821d6cb9

DO - 10.1097/DCR.0b013e31821d6cb9

M3 - Article

VL - 54

SP - 1003

EP - 1007

JO - Diseases of the Colon and Rectum

JF - Diseases of the Colon and Rectum

SN - 0012-3706

IS - 8

ER -