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Comprehensive Review of Anal Cytology
Amanda M Hopp1,2, Andrii Puzyrenko3, Tamara Giorgadze3
1Department of Pathology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA, ahopp@mcw.edu.
Acta Cytologica
|January 10, 2023
Summary
Anal cancer screening is crucial due to rising incidence. Anal cytology, particularly liquid-based, effectively detects abnormalities, though HPV testing and vaccination show promise for prevention and management.
Area of Science:
- Oncology
- Gastroenterology
- Gynecology
Background:
- Anal cancer incidence is rising, particularly in women.
- Standardized screening guidelines are lacking compared to cervical cancer.
- Pathophysiology is similar to cervical cancer, with HPV involvement.
Purpose of the Study:
- Evaluate anal cytology as a screening tool.
- Explore the role of HPV testing and vaccination.
- Assess the efficacy of anoscopy and digital exams in anal cancer screening.
Main Methods:
- Review of anal cytology interpretation using the Bethesda System.
- Analysis of human papillomavirus (HPV) association with anal lesions.
- Examination of digital anorectal exams and anoscopy, including high-resolution anoscopy.
Main Results:
- Anal cytology, especially liquid-based, is an adequate screening tool for anal abnormalities.
- Underestimation of dysplasia and variable concordance are limitations.
- HPV infection is linked to most anal squamous dysplasias and cancers.
Conclusions:
- Anal cytology is a key component of proposed anal cancer screening guidelines.
- HPV testing and vaccination offer potential for screening and prevention.
- Further research, like the ANCHOR trial, is vital for establishing management guidelines.
