Conventional cytologic diagnosis of human papillomavirus‐induced anal intraepithelial neoplasia: The experience of a referral center in Rio de Janeiro, Brazil

• Published in: Diagnostic cytopathology 2023-03, Vol.51 (3), p.166-173
• Main Authors: Barcellos, Lêda Pereira, Coutinho, José Ricardo Hildebrandt, Cytryn, Andrea, Russomano, Fabio Bastos
• Format: Article
• Language: English
• Subjects: Anal Canal - pathology; Anal cancer; Anus; anus neoplasms; Anus Neoplasms - diagnosis; Anus Neoplasms - pathology; Brazil - epidemiology; Carcinoma in Situ - diagnosis; Carcinoma in Situ - epidemiology; Carcinoma in Situ - pathology; Cellular biology; Colorectal cancer; cytological techniques; HIV; HIV Infections - diagnosis; HIV Infections - epidemiology; HIV Infections - pathology; Human immunodeficiency virus; Human Papillomavirus Viruses; Humans; Papillomaviridae; papillomavirus infections; Papillomavirus Infections - diagnosis; Papillomavirus Infections - pathology; secondary prevention
• ISSN: 8755-1039; 1097-0339
• DOI: 10.1002/dc.25079

Background Screening of anal cancer is rarely available or performed in Brazil. This study analyzes the diagnostic performance of conventional cytology (CC) in the prevention of anal cancer in a coloproctology and gynecology outpatient clinics in a public hospital in Rio de Janeiro, Brazil. Methods From 2005 to 2017, 1066 conventional cytological samples were collected. We analyze the causes of unsatisfactory samples (11.3%) and compare the cytological diagnoses of 83 samples from persons living with HIV and persons not living with HIV and in specific situations, using as the gold standard high‐resolution anoscopy or histopathology in cases biopsied within 6 months after cytology. Results The sensitivity of cytology with diagnosis of ASC‐US for detection of anal intraepithelial neoplasia of any grade was 85%, specificity was 41%, positive and negative predictive values were 64% and 75%, respectively, and positive and negative likelihood ratios were 1.46 and 0.35, respectively. Conclusion Conventional cytology available in resource‐limited settings is a simple, noninvasive, low‐cost method that proved feasible for outpatient screening of precursor lesions of the anal canal.