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Histological outcomes of anal high‐grade cytopredictions
Author(s) -
Roberts Jennifer Margaret,
Jin Fengyi,
Poynten Isobel Mary,
Law Carmella,
Templeton David James,
Thurloe Julia Kathleen,
Garland Suzanne Marie,
Grulich Andrew Edwin,
Farnsworth Annabelle,
Hillman Richard John
Publication year - 2018
Publication title -
cancer cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.29
H-Index - 57
eISSN - 1934-6638
pISSN - 1934-662X
DOI - 10.1002/cncy.21936
Subject(s) - medicine , anal cancer , squamous intraepithelial lesion , cytology , histology , prospective cohort study , men who have sex with men , gynecology , abnormality , intraepithelial neoplasia , cancer , gastroenterology , cervical cancer , pathology , cervical intraepithelial neoplasia , prostate cancer , human immunodeficiency virus (hiv) , immunology , syphilis , psychiatry
BACKGROUND Longitudinal studies of histological outcomes after anal cytological screening in men who have sex with men (MSM) are rare. This study measured the positive predictive values (PPVs) of each level of baseline cytological abnormality in MSM in Sydney, Australia, over a 12‐month period. METHODS The Study of the Prevention of Anal Cancer is a 3‐year prospective study of the natural history of anal human papillomavirus infection in MSM at least 35 years old. For each participant with a baseline cytological abnormality, the worst histology was recorded at the baseline high‐resolution anoscopy and at 6 and 12 months. PPVs for a histological high‐grade squamous intraepithelial lesion (HSIL) diagnosis were calculated for each level of baseline cytological abnormality at each time point. RESULTS Among 424 men who completed 3 visits, the PPV of a cytological HSIL increased from 71.6% at the baseline to 86.4% at 6 months and to 92.6% at 12 months ( P < .001). For cytological atypical squamous cells, cannot rule out high‐grade squamous intraepithelial lesion (ASC‐H), the PPV increased from 51.5% at the baseline to 69.7% at 6 months and to 75.8% at 12 months ( P = .004). At each time point, the PPV of a cytological HSIL was significantly higher than the PPV of ASC‐H. The PPV of low‐grade cytology reports was significantly lower than the PPV of ASC‐H at each time point. CONCLUSIONS In a cohort of MSM, a baseline histological HSIL diagnosis after an HSIL cytoprediction is high, and it increases with further examinations over the course of 12 months. Lower levels of cytological abnormalities have significantly lower PPVs. These data can inform patient management and the quality assessment of each aspect of the screening pathway. Cancer Cytopathol 2018;126:136‐44. © 2017 American Cancer Society.