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Anal cytology screening in HIV-positive men who have sex with men: What's new and what's now?

Ho, KS and Cranston, RD (2010) Anal cytology screening in HIV-positive men who have sex with men: What's new and what's now? Current Opinion in Infectious Diseases, 23 (1). 21 - 25. ISSN 0951-7375

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Abstract

PURPOSE OF REVIEW: This review will discuss current and future anal cytology screening programs to detect anal dysplasia in HIV-positive men who have sex with men (MSM), in addition to other interventions aimed at early detection of anal cancer in this population. RECENT FINDINGS: Evidence of progression from high-grade anal dysplasia to anal cancer has been recently demonstrated and strengthens the clinical imperative to diagnose and treat this lesion in at-risk populations. The use of adjunct molecular techniques that improve specificity of anal cytology screening may have the potential to rationalize current screening referral pathways and focus resources on those at highest risk of progressing to cancer. Candidate biomarkers that are currently being investigated include protein surrogates of cell cycle deregulation (such as p16ink4a and minichromosomal maintenance proteins), DNA damage biomarkers (53BP1) in addition to testing for human papillomavirus genotype, gamma tubulin and beta defensin levels. SUMMARY: Anal cytology, although sensitive for the detection of any anal dysplastic abnormality, has poor specificity to detect high-grade anal dysplasia. As new molecular techniques are evolving, the most important immediate clinical intervention is to educate HIV-positive MSM in order to increase awareness of both risk and clinical symptoms suggestive of progression to anal cancer. In the absence of high-resolution anoscopic expertise, it is recommended that regular digital rectal examinations are performed as most early cancers are palpable even in the absence of clinical symptoms. © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Ho, KS
Cranston, RDrdc27@pitt.eduRDC27
Centers: Other Centers, Institutes, Offices, or Units > Center for LGBT Health Research
Date: 1 February 2010
Date Type: Publication
Journal or Publication Title: Current Opinion in Infectious Diseases
Volume: 23
Number: 1
Page Range: 21 - 25
DOI or Unique Handle: 10.1097/qco.0b013e328334fe5a
Schools and Programs: Graduate School of Public Health > Infectious Diseases and Microbiology
Refereed: Yes
ISSN: 0951-7375
Article Type: Review
MeSH Headings: Anal Canal--pathology; Anus Neoplasms--pathology; Anus Neoplasms--virology; Digital Rectal Examination; Early Detection of Cancer--methods; HIV Infections--pathology; Homosexuality, Male; Humans; Male
PubMed ID: 19935419
Date Deposited: 25 Jun 2013 19:29
Last Modified: 02 Feb 2019 16:58
URI: http://d-scholarship.pitt.edu/id/eprint/18936

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