In the last years, the prevalence of HPV infection in the anal region has increased, especially in some groups like homosexual and HIV-positive people. Since this infection can be associated with the development of squamous anal cancer due to its progression from HPV infection to anal intraepithelial neoplasia (AIN) and finally to cancer, the screening and evaluation of these conditions are important. Anal cytology and high resolution anoscopy are good methods that are available and can be used. Although useful, these methods should be performed correctly and not indiscriminately in all patients. Patients for whom anal cytology screening is recommended are: HIV-infected patients, homosexuals, women who present with high-grade vulvar squamous intraepithelial neoplasia, vulvar cancer or cervical cancer. An abnormal anal cytology should be further evaluated with high resolution anoscopy.
Journal Information
Vol. 15. Issue 5.
Pages 473-477 (September - October 2011)
Vol. 15. Issue 5.
Pages 473-477 (September - October 2011)
Review Article
Open Access
HPV infection and intraepithelial lesions from the anal region: how to diagnose?
Visits
2968
Newton Sérgio de Carvalho1, Aliana Meneses Ferreira2,
, Camila Caroline Tremel Bueno2
Corresponding author
ali_ferreira@hotmail.com
Correspondence to: Rua General Carneiro, 181, Alto da Glória 80060-150, Curitiba, PR, Brazil.
Correspondence to: Rua General Carneiro, 181, Alto da Glória 80060-150, Curitiba, PR, Brazil.
1 Professor of Infectious Diseases, Gynecology and Obstetrics Sector, Department of ObGyn, Hospital de Clínicas, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil
2 Members in Training Infectious Diseases, Gynecology and Obstetrics Sector, Department of ObGyn, Hospital de Clínicas, UFPR, Curitiba, PR, Brazil
This item has received
Article information
Abstract
Keywords:
anal canal
papillomavirus infections
cell biology
carcinoma in situ
Full text is only aviable in PDF
References
[1.]
D.M. Parkin.
The global health burden of infection-associated cancers in the year 2002.
Int J Cancer, 118 (2006), pp. 3030-3044
[2.]
D.A. Joseph, J.W. Miller, X. Wu, et al.
Understanding the burden of human papillomavirus-associated anal cancers in the US.
Cancer, 113 (2008), pp. 2892-2900
[3.]
N. Jay, M. Berry, C.J. Hogeboorn, et al.
Colposcopic appearance of anal squamous intraepithelial lesions.
Dis Col Rectum, 40 (1997), pp. 919-928
[4.]
J. Palefski, J. Gonzales, R.M. Greenblatt, et al.
Anal intraepithelial neoplasia and anal papillomavirus infection among homosexual males with group IV HIV disease.
JAMA, 263 (1990), pp. 2911-2916
[5.]
J.M. Palefsky, E.A. Holly, M.L. Ralston, et al.
Prevalence and risk factors for human papillomavirus infection of the anal canal in immunodeficiency virus HIV-positive and HIV-negative homosexual men.
J Infect Dis, 177 (1998), pp. 361
[6.]
S.R. Nadal, S.H.C. Horta, E.E. Calore, et al.
How deep must the brush be introduced in the anal canal for a more effective cytological evaluation?.
Rev Assoc Med Bras, 55 (2009), pp. 749-751
[7.]
S.M. Bean, D.C. Chhieng.
Anal-rectal cytology: a review.
Diagn Cytopathol, 38 (2010), pp. 538-546
[8.]
J.R.H. Coutinho.
Premalignant screening for anal lesions – anal cytology and high resolutions anoscopy. New resources for prevention.
Rev Col Bras Cir, 33 (2006), pp. 311-317
[9.]
R.D. Cranston, T.M. Darragh, E.A. Holly, et al.
Anal intraepithelial neoplasia: diagnosis, screening and treatment.
J Acquir Immune Defic Syndr, 36 (2004), pp. 915-920
[10.]
C.S. Nahas, E.V. da Silva Filho, A.A. Segurado, et al.
Screening anal dysplasia in HIV-infected patients: is there an agreement between anal pap smear and high-resolution anoscopy-guided biopsy?.
Dis Colon Rectum, 52 (2009), pp. 1854-1860
[11.]
J.T. Santoso, M. Long, M. Crigger, et al.
Anal Intraepithelial neoplasia in women with genital intraepithelial neoplasia.
Obstet Gynecol, 116 (2010), pp. 578-582
[12.]
P.A. Fox.
Human papillomavirus and anal intraepithelial neoplasia.
Curr Opin Infect Dis, 19 (2006), pp. 62-66
[13.]
D. Parés, J. Mullerat, M. Pera.
Anal intraepithelial neoplasia.
Med Clin (Barc), 127 (2006), pp. 749-755
[14.]
C.M. Vajdic, J.S. Anderson, R.J. Hillman, et al.
Blind sampling is superior to anoscope guided sampling for screening for anal intreapithelial neoplasia.
Sex Transm Infect, 81 (2005), pp. 415-418
[15.]
A. Ruiter, P. Carter, D.R. Katz, et al.
A comparison between cytology and histology to detect anal intraepithelial neoplasia.
Genitourin Med, 70 (1994), pp. 22-25
[16.]
E.Y. Chiao, T.P. Giordano, J.M. Palefsky, et al.
Screening HIV-infected individuals for anal cancer precursor lesions: a systematic review.
Clin Infect Dis, 43 (2006), pp. 223-233
[17.]
I.U. Park, J.M. Palefsky.
Evaluation and Management of anal intraepithelial neoplasia in HIV-negative and HIV-positive men who have sex with men.
Curr Infect Dis Rep, 12 (2010), pp. 126-133
[18.]
P.A. Fox.
Anal cancer screening in men who have sex with men.
Curr Opin HIV AIDS, 4 (2009), pp. 64-67
[19.]
A.M. Metcalf, T. Dean.
Risk of dysplasia in anal condyloma.
Surgery, 118 (1995), pp. 724-726
[20.]
J.M. Palefsky, E.A. Holly, J. Gonzales, et al.
Natural history of anal cytologic abnormalities and papillomavirus infection among homosexual men with group IV HIV disease.
J AIDS, 5 (1992), pp. 1258-1265
[21.]
A.B. Moscicki, N.K. Hills, S. Shiboski, et al.
Risk factors for abnormal anal cytology in young heterosexual women.
Cancer Epidemiol Biomarkers Prev, 8 (1999), pp. 173-178
[22.]
E.A. Holly, M.L. Ralston, T.M. Darragh, et al.
Prevalence and risk factors for anal squamous intraepithelial lesions in women.
JNCI J Natl Cancer Inst, 93 (2001), pp. 843-849
[23.]
I.U. Park, J.W. Ogilvie Jr., K.E. Anderson, et al.
Anal human papillomavirus infection and abnormal anal cytology in women with genital neoplasia.
Gynecol Oncol, 114 (2009), pp. 399-403
[24.]
R.M. Zanine, A.P.W. Fabro, D.B. Gomez, et al.
Prevalence of abnormal anal cytology in women with abnormal Pap smear.
Rev Bras Genitoscopia, 3 (2009), pp. 76-79
[25.]
P. Giraldo, C. Jacyntho, C. Costa, et al.
Prevalence of anal squamous intra-epithelial lesion in women presenting genital squamous intra-epithelial lesion.
Eur J Obstet Gynecol Reprod Biol, 142 (2009), pp. 73-75
[26.]
N.A. Hessol, E.A. Holly, J.T. Efird, et al.
Anal intraepithelial neoplasia in a multiside study oh HIV-infected and high-risk-HIV-uninfected women.
AIDS, 23 (2009), pp. 59-70
[27.]
R. Tandon, A.S. Baranoski, F. Huang, et al.
Abnormal anal cytology in HIV-infected women.
Am J Obstet Gynecol, 203 (2010), pp. 21.e1-21.e6
[28.]
A.B. Williams, T.M. Darragh, K. Vranizan, et al.
Anal and cervical human papillomavirus infection and risk of anal and cervical epithelial abnormalities in human immunodeficiency virusinfected women.
Obstet Gynecol, 83 (1994), pp. 205-211
Copyright © 2011. Elsevier Editora Ltda.. All rights reserved