Anal-rectal cytology as a screening tool for the detection of anal intraepithelial neoplasia in HIV-positive men

IntroductionUse of anal-rectal cytology is on the rise as a screening tool for the detection of anal squamous lesions in human immunodeficiency virus (HIV)–positive individuals. The purpose of this 5-year retrospective study was to determine the utility of routine anal-rectal screening for the detection of squamous lesions in HIV-positive patients with histology correlation.Materials and methodsFrom January 1, 2008 through December 31, 2012, 448 anal-rectal Papanicolaou tests were performed on HIV-positive men, of which 133 were referred for high-resolution anoscopy.ResultsOf the 448 cases, 184 (41%) were classified as atypical squamous cells of undetermined significance or above, of which 133 (72%) had histologic correlation. Nine (7%) were negative, 64 (48%) were anal intraepithelial neoplasia (AIN) 1, 36 (27%) were AIN 2, 21 (16%) were AIN 3, and 3 (2%) were squamous cell carcinoma.ConclusionsThe results of this study support the use of anal-rectal cytology as a screening tool in the detection of anal intraepithelial neoplasia, particularly in high-risk populations.