Evaluation of anal cytology and human papillomavirus infection in high-risk women: a cross-sectional study

  • Tahereh Ashrafganjoei Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • Maryam Sadat Hosseini Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • Zanbagh Pirastehfar Department of Obstetrics and Gynecology, School of Medicine, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran https://orcid.org/0000-0002-0655-988X
  • Farah Farzaneh Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran https://orcid.org/0000-0002-5062-4386
  • Maliheh Arab Department of Obstetrics and Gynecology, School of Medicine, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • Noushin Ashfar Moghaddam Department of Pathology, School of Medicine, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • Abdolreza Javadi Department of Pathology, School of Medicine, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • Ali Yaghobi Joybari Department of Radiotherapy, School of Medicine, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
DOI: https://doi.org/10.13181/mji.oa.236375
Keywords: anal neoplasms, cytology, human papillomavirus, Papanicolaou test, uterine cervical neoplasms
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Abstract

BACKGROUND Anal cancer incidence has been on the rise over the past few decades. This study aimed to assess anal Papanicolaou (Pap) smear changes in women with high risk for dysplasia and human papillomavirus (HPV) infection.

METHODS This cross-sectional study was conducted on 121 patients referred to the Gynecology Oncology Clinic of Imam Hossein Medical Center between 2020 and 2021 in Tehran, Iran, who had cervical and vulvar dysplasia, cervical HPV infection, and abnormal cervical cytology results and were over 21 years old. Data analysis was performed using SPSS software version 21 (IBM Corp., USA) at a significance level of 0.05.

RESULTS 121 women, with a mean age of 39.69 years, were included in this study. Overall, 23.1% of women had positive anal HPV results, and 35.5% were over 40 years old. Younger age was associated with an increased risk of anal HPV (p = 0.045). 33.9% of women were single and had a higher risk of anal HPV. Multiple sexual partnerships and anal sex were the significant risk factors for anal cancer (p<0.001). Women with positive anal HPV results had significantly more genital warts (p<0.001). No significant difference was observed in smoking, educational level, and cervical Pap smear results between women with negative and positive rectal HPV results.

CONCLUSIONS Younger age at diagnosis, being single, having multiple sexual partnerships, having anal sex, and having genital warts were associated with anal HPV infection in women. Abnormal anal cytology was only associated with being single and having multiple sexual partners.

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References

  1. Saleem AM, Paulus JK, Shapter AP, Baxter NN, Roberts PL, Ricciardi R. Risk of anal cancer in a cohort with human papillomavirus-related gynecologic neoplasm. Obstet Gynecol. 2011;117(3):643-9. https://doi.org/10.1097/AOG.0b013e31820bfb16

  2. National Cancer Institute. Cancer Stat Facts: Anal Cancer [Internet]. National Cancer Institute; 2022 [cited 2022 Oct 20]. Available from: https://seer.cancer.gov/statfacts/html/anus.html.

  3. Stier EA, Chiao EY. Anal cancer and anal cancer precursors in women with a history of HPV-related dysplasia and cancer. Semin Colon Rectal Surg. 2017;28(2):97-101. https://doi.org/10.1053/j.scrs.2017.04.008

  4. van Eer K, Laâbi I, van Benthem BH, Steenbergen RDM, King AJ, Medical Microbiological Laboratories and the Public Health Services: Medical Microbiological Laboratories: Certe; et al. The association between viral load and concurrent human papillomavirus infection at the genital and anal sites of young women and the impact of vaccination. Tumour Virus Res. 2022; 13:200233. https://doi.org/10.1016/j.tvr.2021.200233

  5. Aguiar C, García L, Boccardo MB, Vassel M, Arriola A, Jaumandreu S, et al. Anal PAP, HPV tests and magnifying chromoendoscopy with biopsies in the diagnosis of anal intraephitelial neoplasia. J Coloproctology. 2020;40(3):220-6. https://doi.org/10.1016/j.jcol.2020.05.003

  6. Krzowska-Firych J, Lucas G, Lucas C, Lucas N, Pietrzyk Ł. An overview of human papillomavirus (HPV) as an etiological factor of the anal cancer. J Infect Public Health. 2019;12(1):1-6. https://doi.org/10.1016/j.jiph.2018.06.005

  7. Tatti S, Suzuki V, Fleider L, Maldonado V, Caruso R, Tinnirello Mde L. Anal intraepithelial lesions in women with human papillomavirus-related disease. J Low Genit Tract Dis. 2012;16(4):454-9. https://doi.org/10.1097/LGT.0b013e31825d2d7a

  8. Hosseini MS, Khosravi D, Farzaneh F, Ebrahimi A, Arab M, Ashraf Ganjoie T, et al. Evaluation of anal cytology in women with history of abnormal pap smear, cervical intraepithelial neoplasia, cervical cancer and high risk hpv for anogenital dysplasia. Asian Pac J Cancer Prev. 2018;19(11):3071-5. https://doi.org/10.31557/APJCP.2018.19.11.3071

  9. Lin C, Slama J, Gonzalez P, Goodman MT, Xia N, Kreimer AR, et al. Cervical determinants of anal HPV infection and high-grade anal lesions in women: a collaborative pooled analysis. Lancet Infect Dis. 2019;19(8):880-91. https://doi.org/10.1016/S1473-3099(19)30164-1

  10. Inthasorn P, Wetpithayakom N, Laiwejpithaya S, Lohsiriwat V, Jaishuen A, Viriyapak B. Prevalence of abnormal anal cytology in women with abnormal cervical cytology. Asian Pac J Cancer Prev. 2021;22(7):2165-9. https://doi.org/10.31557/APJCP.2021.22.7.2165

  11. Lin C, Franceschi S, Clifford GM. Human papillomavirus types from infection to cancer in the anus, according to sex and HIV status: a systematic review and meta-analysis. Lancet Infect Dis. 2018;18(2):198-206. https://doi.org/10.1016/S1473-3099(17)30653-9

  12. Moscicki AB, Darragh TM, Berry-Lawhorn JM, Roberts JM, Khan MJ, Boardman LA, et al. Screening for anal cancer in women. J Low Genit Tract Dis. 2015;19(3 Suppl 1):S27-42. https://doi.org/10.1097/LGT.0000000000000117

  13. van der Zee RP, Richel O, de Vries HJ, Prins JM. The increasing incidence of anal cancer: can it be explained by trends in risk groups? Neth J Med. 2013;71(8):401-11.

  14. Calore EE, Giaccio CM, Nadal SR. Prevalence of anal cytological abnormalities in women with positive cervical cytology. Diagn Cytopathol. 2011;39(5):323-7. https://doi.org/10.1002/dc.21386

Published
2023-03-30
How to Cite
1.
Ashrafganjoei T, Sadat Hosseini M, Pirastehfar Z, Farzaneh F, Arab M, Moghaddam NA, Javadi A, Joybari AY. Evaluation of anal cytology and human papillomavirus infection in high-risk women: a cross-sectional study. Med J Indones [Internet]. 2023Mar.30 [cited 2024Jul.3];31(4):245-9. Available from: http://mji.ui.ac.id/journal/index.php/mji/article/view/6375
Issue
Vol. 31 No. 4 (2022): December
Section
Clinical Research

Copyright (c) 2023 Tahereh Ashrafganjoei , Maryam Sadat Hosseini, Zanbagh Pirastehfar, Farah Farzaneh , Maliheh Arab , Noushin Ashfar Moghaddam , Abdolreza Javadi, Ali Yaghobi Joybari

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