36. Anal cytology and HPV genotyping in women with lower genital tract neoplasia

Abstract

Objective: To compare the prevalence of abnormal anal cytology and high-risk HPV among women with a recent history of HPV-related genital neoplasia to women without a history of HPV-related genital neoplasia. Methods: A cross-sectional pilot study was performed. Women with a history of high-grade cervical, vulvar, or vaginal dysplasia or cancer within the past 2 years were eligible for the exposed group. Women without a history of high-grade anogenital dysplasia or cancer were eligible for the control group. Anal cytology and HPV genotyping were performed after informed consent was obtained. Results: 127 women were enrolled in the exposed group and 45 in the control group. The control group was slightly older and less likely to be current smokers. There was no difference between groups in history of anal intercourse. Forty-four per cent of the exposed group had abnormal anal cytology compared with 21.6% of the control group (P = 0.03). High-risk HPV was detected in the anal canal of 6 in the exposed group compared with none in the control group (P = 0.2). Fourteen per cent of the anal cytology results were read as insufficient in both groups. HPV results were insufficient in 29.2% of exposed versus 43.5% of control (P = 0.2). Conclusions: Women with a history of lower genital tract dysplasia are more likely to have a positive anal cytology result compared with women without a history. Additional information is needed to determine the best method of anal cancer screening among women with a history of lower genital tract dysplasia.