Year 2017 / Volume 109 / Number 4
Original
Preliminary results of a screening program for anal cancer and its precursors for HIV-infected men who have sex with men in Vigo-Spain

242-249

DOI: 10.17235/reed.2017.4274/2016

Mauricio Iribarren Díaz, Antonio Ocampo Hermida, Joaquín González-Carreró Fojón, Rebeca Longueira Suárez, Alberto Rivera Gallego, Enrique Casal Núñez, Antón Ocampo Álvarez, Edward R. Cachay,

Abstract
Background: Men who have sex with men (MSM) infected with human immunodeficiency virus (HIV) have the highest risk of developing anal cancer (AC). The objective of this study was to describe our screening implementation program in this population, and report the prevalence of human papillomavirus (HPV) anal infection, and cytological and histological findings in a Spanish medium-size community (Vigo, Spain). Method: Prospective cohort analysis of 240 HIV-infected MSM. Cellular anal sample and high risk HPV (HR-HPV)-tests were performed to study cytological changes and HPV genotyping. High resolution anoscopy (HRA) was performed in 209 patients. Results were analyzed with respect to epidemiological, clinical and analytical factors. Results: Of 209 patients selected for HRA, the prevalence of HR-HPV anal infection, cytological and histological alterations was 85.6%, 47.5%, and 39.8%, respectively. Sensitivity and specificity for ≥ ASCUS (atypia of squamous cells of undetermined significance) cytology in relation to histological alterations were 61% and 85%, (OR: 8.7; IC 95%: 4.4-17.2), respectively. Observed concordance between high-grade squamous intraepithelial lesion (HSIL) cytology and HSIL anal intraepithelial neoplasia types 2 and 3 (AIN-2/3) histology was 64% (OR: 11.4; IC 95%: 3.6-36.7). One patient with HSIL cytology presented a prevalent anal squamous carcinoma. Conclusions: HRA was feasible with similar results to relevant groups. There was a high prevalence of anal HR-HPV infection, and cytological and histological alterations.
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References
1. Bosch FX, Broker TR, Forman D, Moscicki AB, Gillison ML, Doorbar J, et al. Comprehensive control of human papillomavirus infections and related diseases. Vaccine. 2013;31 Suppl 7:H1-31.
2. Hoots BE, Palefsky JM, Pimenta JM, Smith JS. Human papillomavirus type distribution in anal cancer and anal intraepithelial lesions. International journal of cancer Journal international du cancer. 2009;124(10):2375-83.
3. Moody CA, Laimins LA. Human papillomavirus oncoproteins: pathways to transformation. Nature reviews Cancer. 2010;10(8):550-60.
4. Sirera G, Videla S, Pinol M, Canadas MP, Llatjos M, Ballesteros AL, et al. High prevalence of human papillomavirus infection in the anus, penis and mouth in HIV-positive men. Aids. 2006;20(8):1201-4.
5. Chin-Hong PV, Palefsky JM. Human papillomavirus anogenital disease in HIV-infected individuals 2005.
6. Shiels MS, Pfeiffer RM, Hildesheim A, Engels EA, Kemp TJ, Park JH, et al. Circulating inflammation markers and prospective risk for lung cancer. Journal of the National Cancer Institute. 2013;105(24):1871-80.
7. Robinson D, Coupland V, Moller H. An analysis of temporal and generational trends in the incidence of anal and other HPV-related cancers in Southeast England. British journal of cancer. 2009;100(3):527-31.
8. Frisch M. On the etiology of anal squamous carcinoma. Danish medical bulletin. 2002;49(3):194-209. Epub 2002/09/20.
9. Goldstone SE, Johnstone AA, Moshier EL. Long-term outcome of ablation of anal high-grade squamous intraepithelial lesions: recurrence and incidence of cancer. Diseases of the colon and rectum. 2014;57(3):316-23. Epub 2014/02/11.
10. Sendagorta E, Herranz P, Guadalajara H, Zamora FX. [Early detection of anal intraepithelial neoplasia in high-risk patients]. Actas dermo-sifiliograficas. 2011;102(10):757-65. Deteccion precoz de la neoplasia intraepitelial anal en pacientes de alto riesgo.
11. Chiao EY, Giordano TP, Palefsky JM, Tyring S, El Serag H. Screening HIV-infected individuals for anal cancer precursor lesions: a systematic review. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2006;43(2):223-33.
12. D'Souza G, Wiley DJ, Li X, Chmiel JS, Margolick JB, Cranston RD, et al. Incidence and epidemiology of anal cancer in the multicenter AIDS cohort study. Journal of acquired immune deficiency syndromes. 2008;48(4):491-9. Epub 2008/07/11.
13. Powles T, Robinson D, Stebbing J, Shamash J, Nelson M, Gazzard B, et al. Highly active antiretroviral therapy and the incidence of non-AIDS-defining cancers in people with HIV infection. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2009;27(6):884-90. Epub 2008/12/31.
14. Berry JM, Palefsky JM, Jay N, Cheng SC, Darragh TM, Chin-Hong PV. Performance characteristics of anal cytology and human papillomavirus testing in patients with high-resolution anoscopy-guided biopsy of high-grade anal intraepithelial neoplasia. Diseases of the colon and rectum. 2009;52(2):239-47.
15. Cachay ER, Mathews WC. Human papillomavirus, anal cancer, and screening considerations among HIV-infected individuals. AIDS reviews. 2013;15(2):122-33.
16. Lam JM, Hoch JS, Tinmouth J, Sano M, Raboud J, Salit IE. Cost-effectiveness of screening for anal precancers in HIV-positive men. Aids. 2011;25(5):635-42.
17. Mathews C, Caperna J, Cachay ER, Cosman B. Early impact and performance characteristics of an established anal dysplasia screening program: program evaluation considerations. The open AIDS journal. 2007;1:11-20.
18. Swedish KA, Lee EQ, Goldstone SE. 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. Diseases of the colon and rectum. 2011;54(8):1003-7. Epub 2011/07/07.
19. al LJe. European AIDS Clinical Society Guidelines: Prevention and Management of Non-Infectious Co-Morbidities in HIV. 2009.
20. Truesdale MD, Goldstone SE. The fear factor: drivers and barriers to follow-up screening for human papillomavirus-related anal cancer in men who have sex with men. International journal of STD & AIDS. 2010;21(7):482-8.
21. Solomon D, Davey D, Kurman R, Moriarty A, O'Connor D, Prey M, et al. The 2001 Bethesda System: terminology for reporting results of cervical cytology. JAMA : the journal of the American Medical Association. 2002;287(16):2114-9.
22. Nathan M, Singh N, Garrett N, Hickey N, Prevost T, Sheaff M. Performance of anal cytology in a clinical setting when measured against histology and high-resolution anoscopy findings. Aids. 2010;24(3):373-9. Epub 2010/01/09.
23. Chin-Hong PV, Palefsky JM. Natural history and clinical management of anal human papillomavirus disease in men and women infected with human immunodeficiency virus. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2002;35(9):1127-34. Epub 2002/10/18.
24. Iribarren-Diaz M, Ocampo Hermida A, Gonzalez-Carrero Fojon J, Alonso-Parada M, Rodriguez-Girondo M. [Practical considerations for high resolution anoscopy in patients infected with human immunodeficiency virus]. Enfermedades infecciosas y microbiologia clinica. 2014;32(10):676-80. Epub 2013/11/05. Consideraciones practicas de la anoscopia de alta resolucion en pacientes infectados por el virus de la inmunodeficiencia humana.
25. Darragh TM, Colgan TJ, Cox JT, Heller DS, Henry MR, Luff RD, et al. The Lower Anogenital Squamous Terminology Standardization Project for HPV-Associated Lesions: background and consensus recommendations from the College of American Pathologists and the American Society for Colposcopy and Cervical Pathology. Journal of lower genital tract disease. 2012;16(3):205-42. Epub 2012/07/24.
26. Torres M, Gonzalez C, del Romero J, Viciana P, Ocampo A, Rodriguez-Fortunez P, et al. Anal human papillomavirus genotype distribution in HIV-infected men who have sex with men by geographical origin, age, and cytological status in a Spanish cohort. Journal of clinical microbiology. 2013;51(11):3512-20.
27. Aldrich MC, Hidalgo B, Widome R, Briss P, Brownson RC, Teutsch SM. The role of epidemiology in evidence-based policy making: a case study of tobacco use in youth. Annals of epidemiology. 2015;25(5):360-5. Epub 2014/05/31.
28. Panther LA, Wagner K, Proper J, Fugelso DK, Chatis PA, Weeden W, et al. High resolution anoscopy findings for men who have sex with men: inaccuracy of anal cytology as a predictor of histologic high-grade anal intraepithelial neoplasia and the impact of HIV serostatus. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2004;38(10):1490-2. Epub 2004/05/25.
29. Cranston RD, Hart SD, Gornbein JA, Hirschowitz SL, Cortina G, Moe AA. The prevalence, and predictive value, of abnormal anal cytology to diagnose anal dysplasia in a population of HIV-positive men who have sex with men. International journal of STD & AIDS. 2007;18(2):77-80. Epub 2007/03/03.
30. Weis SE, Vecino I, Pogoda JM, Susa JS, Nevoit J, Radaford D, et al. Prevalence of anal intraepithelial neoplasia defined by anal cytology screening and high-resolution anoscopy in a primary care population of HIV-infected men and women. Diseases of the colon and rectum. 2011;54(4):433-41. Epub 2011/03/09.
31. Patel J, Salit IE, Berry MJ, de Pokomandy A, Nathan M, Fishman F, et al. Environmental scan of anal cancer screening practices: worldwide survey results. Cancer medicine. 2014;3(4):1052-61. Epub 2014/04/18.
32. Siekas LL, Aboulafia DM. Establishing an anal dysplasia clinic for HIV-infected men: initial experience. The AIDS reader. 2009;19(5):178-86.
33. Law C. “Towards the development of robust quality assurance (QA) metrics for high resolution anoscopy (HRA)”. Second International Anal Neoplasia Scientific Meeting. Atlanta USA. March 13-15, 2015.
34. Machalek DA, Poynten M, Jin F, Fairley CK, Farnsworth A, Garland SM, et al. Anal human papillomavirus infection and associated neoplastic lesions in men who have sex with men: a systematic review and meta-analysis. The lancet oncology. 2012;13(5):487-500.
35. Darwich L, Videla S, Canadas MP, Pinol M, Garcia-Cuyas F, Vela S, et al. Distribution of human papillomavirus genotypes in anal cytological and histological specimens from HIV-infected men who have sex with men and men who have sex with women. Diseases of the colon and rectum. 2013;56(9):1043-52.
36. Hidalgo-Tenorio C, Rivero-Rodriguez M, Gil-Anguita C, Esquivias J, Lopez-Castro R, Ramirez-Taboada J, et al. The role of polymerase chain reaction of high-risk human papilloma virus in the screening of high-grade squamous intraepithelial lesions in the anal mucosa of human immunodeficiency virus-positive males having sex with males. PloS one. 2015;10(4):e0123590. Epub 2015/04/08.
37. Fox PA, Seet JE, Stebbing J, Francis N, Barton SE, Strauss S, et al. The value of anal cytology and human papillomavirus typing in the detection of anal intraepithelial neoplasia: a review of cases from an anoscopy clinic. Sexually transmitted infections. 2005;81(2):142-6.
38. Mathews WC, Sitapati A, Caperna JC, Barber RE, Tugend A, Go U. Measurement characteristics of anal cytology, histopathology, and high-resolution anoscopic visual impression in an anal dysplasia screening program. Journal of acquired immune deficiency syndromes. 2004;37(5):1610-5. Epub 2004/12/04.
39. Richel O, Prins JM, de Vries HJ. Screening for anal cancer precursors: what is the learning curve for high-resolution anoscopy? Aids. 2014;28(9):1376-7. Epub 2014/06/17.
40. Palefsky JM. Practising high-resolution anoscopy. Sexual health. 2012;9(6):580-6.
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Iribarren Díaz M, Ocampo Hermida A, González-Carreró Fojón J, Longueira Suárez R, Rivera Gallego A, Casal Núñez E, et all. Preliminary results of a screening program for anal cancer and its precursors for HIV-infected men who have sex with men in Vigo-Spain. 4274/2016


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Publication history

Received: 17/02/2016

Accepted: 22/12/2016

Online First: 23/02/2017

Published: 31/03/2017

Article revision time: 300 days

Article Online First time: 372 days

Article editing time: 408 days


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