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Unlabelled: Background Anal cancer is increasing in incidence, has very high rates in specific populations and shares many similarities with cervical cancer. High-grade squamous intraepithelial lesions (HSIL) are regarded as precursors to anal cancer. High resolution anoscopy (HRA), which is derived from colposcopy, is the only currently available tool that can identify areas of the anal canal for targeted biopsy and identification of HSIL.Methods: This study investigated the ability over a period of time of a single anoscopist to identify and adequately biopsy HSIL, correlating with contemporary anal cytological findings.Results: Four hundred paired cytology and histology samples collected from 283 patients over a 7-year period from 2004 to 2010 were compared. There was a significant increase in HSIL detection rates when anal squamous cells of undetermined significance (ASC-US; 38.6-66.0%) or low-grade squamous intra-epithelial lesion (38.8-68.3%) were taken as cut-off points (P<0.001 for both). Detection rates did not change significantly when atypical squamous cells-cannot exclude HSIL (ASC-H) or a higher grade lesion (70-76.6%) was taken as the cut-off point.Conclusions: The increase in ability to detect histological HSIL over time and with increasing experience has the potential to impact on delivery of clinical services and the interpretation of clinical trial data. Further studies are required to determine the extent of this effect on other clinicians practising HRA. [ABSTRACT FROM AUTHOR]

The article offers information on a study which evaluated the sensitivity and specificity of cytology against histopathology in patients who were referred within the sexual health clinic with a record of abnormal anal cytology or clinical evidence of anal warts. The relationship between cellular evidence of anal disease and high risk human papilloma virus (hrHPV) and HIV infections is explored. Data analyzed were from the results of paired anal cytology and histopathology specimens collected between 2002 and 2008. A discussion on the research findings is detailed.

Neoplasia is the second most common cause of mortality in HIV patients. The prevalence of anal cancer among men who have sex with men (MSM) has continued to increase since the introduction of antiretroviral therapy. We screened 94 HIV-infected MSM patients. We found high-grade squamous intraepithelial lesions (HSIL) in six of the patients. The calculated prevalence of HSIL was 6.4% (95% confidence interval: 2.9-13.2). The study and implementation of screening programs for high-risk groups is a priority. [ABSTRACT FROM AUTHOR]

The article discusses the reporting of anal cytology and histology samples and the establishment of terminology and criteria. The authors utilise cervical reporting of cytological and histological specimens as the basis for the development of standardised and evidence-based terminology and criteria for the reporting of anal specimens. The authors support the use of the Australian Modified Bethesda System 2004 for reporting anal cytology and propose the use of a two-tiered histological reporting system for non-invasive disease and low-grade and high-grade anal intraepithelial neoplasia.

The article presents a study on the epidemiology and natural history of anal human papillomavirus (HPV) infection in men who have sex with men (MSM). According to the author, studies on the epidemiology and natural history of anal HPV infection are important to understand the significance of the virus in the aetiology of anal cancer in MSM. The study found that factors associated with anal HPV detection include history of receptive anal intercourse, number of male sexual partners, and history of anal warts.

The article describes the technique of high-resolution anoscopy (HRA) as well as its uses and challenges for the prevention of anal cancer. According to the author, anal cancer is similar to cervical cancer and is linked with human papillomavirus (HPV) and is potentially preventable through primary prevention with HPV vaccination or secondary prevention. The author notes that HRA poses several additional challenges compared with cervical colposcopy including uneven topography, obscuring of lesions due to hemorrhoids, and lesions located at the base of folds and anal glands.

The article presents a comparative study of the performance of anal cytology and cervical cytology as screening tests. According to the author, cervical cytology screening has a long history and has successfully lowered the impact of cervical cancer in many countries. The author notes that the performance of cytology as a screening test in previous studies varies widely but it is essential to understand that some of this variability is because of differences in the definitions of important parameters in the various studies.