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The performance of anal cytology as a screening test for anal HSILs in homosexual men.
Open accessAbstract
BACKGROUND: Studies regarding the performance of anal cytology in which both the screening test (cytology) and the diagnostic test (high-resolution anoscopy [HRA]) are performed in all members of a screening population are rare. The authors evaluated the performance of liquid-based anal cytology in a cohort of homosexual men in Sydney, New South Wales, Australia. METHODS: The Study of the Prevention of Anal Cancer (SPANC) is a 3-year prospective study of the natural history of anal human papillomavirus infection in homosexual men aged ≥35 years. At baseline, all participants underwent a liquid-based anal cytology test and HRA at the same clinical visit. Biopsies were obtained for histological assessment if lesions suspicious for human papillomavirus infection were visible during HRA. Using any cytological abnormality as the threshold, the sensitivity, specificity, and positive and negative predictive values were calculated against histologically diagnosed high-grade squamous intraepithelial lesions (HSILs). RESULTS: Among 617 men recruited, the median age was 49 years (range, 35-79 years) and 35.7% were positive for the human immunodeficiency virus. Overall, the sensitivity of cytology was 83.2%, the specificity was 52.6%, the positive predictive value was 45.8%, and the negative predictive value was 86.7%. Specificity improved with increasing age (P for trend =.041). Sensitivity was significantly higher in men with >1 anal octant of biopsy-confirmed HSIL (92.9% vs 77.7%; P = .010), and in those who had ≥10 metaplastic cells present on their cytology slides (87.5% vs 70.2%; P = .007). CONCLUSIONS: Anal cytology was found to have a higher specificity in older men while maintaining sensitivity. Sensitivity was higher among those with more extensive HSILs and men with metaplastic cells present on cytology. Cancer Cytopathol 2016;124:415-24. © 2016 American Cancer Society.
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Sensitivity and specificity of anal cytology to detect HSIL are limited (sensitivity 55%-89% and specificity 40%-67%).
“Sensitivity and specificity of anal cytology to detect HSIL are limited (sensitivity 55%–89% and specificity 40%–67%) (1286–1291).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [1286]
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Sexually Transmitted Infections Treatment Guidelines, 2021
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Metadata
- Authors
- Jin, F., Grulich, A. E., Poynten, I. M., Hillman, R. J., Templeton, D. J., Law, C. L. H., Farnsworth, A., Garland, S. M., Fairley, C. K., Roberts, J. M., & and on behalf of the SPANC Study Team
- Affiliations
- UNSW Sydney (AU)
- The University of Sydney (AU)
- St Vincent's Hospital Sydney (AU)
- Douglass Hanly Moir Pathology (AU)
- Royal Women's Hospital (AU)
- Melbourne Sexual Health Centre (AU)
- Corresponding author
- Jin, Fengyi
- ORCID
- Venue
- Cancer Cytopathology
- Publisher
- Wiley
- Published
- 2016-02-24
- Volume
- 124
- Issue
- 6
- Pages
- 415-424
- ISSN
- 1934-662X (ISSN-L)
- 1934-6638
- OpenAlex
- W2283065470
- Cited by
- 45
- References
- 40
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 5 · 2023: 3 · 2022: 4 · 2021: 6 · 2020: 3 · 2019: 4 · 2018: 5 · 2017: 8 · 2016: 3
- FWCI
- 6.24
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Cancer Cytopathology (publishedVersion)
- PubMed (publishedVersion)
- Monash University Research Portal (Monash University) (submittedVersion, other-oa)
- UNSWorks (UNSW Sydney) (submittedVersion, cc-by-nc-nd)
- Minerva Access (University of Melbourne) (submittedVersion)
- Funders
- GlaxoSmithKline
- Sanofi
- Australian Government
- University of New South Wales
- Sanofi Pasteur
- Medical Research Council
- National Health and Medical Research Council (1016307, 1013353, 568971, 1081175)
- Topics
- Health Sciences › Medicine › Epidemiology › Cervical Cancer and HPV Research
- Health Sciences › Medicine › Surgery › Colorectal and Anal Carcinomas
- Health Sciences › Medicine › Surgery › Genital Health and Disease
- Keywords
- anal cytology, liquid-based cytology, high-grade squamous intraepithelial lesion, anal cancer screening, gay men, HPV infection, high-resolution anoscopy, diagnostic accuracy, metaplastic cells, HIV-positive men
- MeSH terms
- Adult, Aged, Anus Neoplasms, Australia, Carcinoma, Squamous Cell, Cytodiagnosis, Female, HIV Seropositivity, Humans, Longitudinal Studies, Male, Middle Aged, Prospective Studies, HIV Infections, Homosexuality, Male, Papillomaviridae, Papillomavirus Infections, Squamous Intraepithelial Lesions of the Cervix
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