Article Text

PDF

OC-071 Screening For Anal Pre-cancer In Hiv Positive And Negative Men Who Have Sex With Men (msm) And Renal Transplant Recipients: Early Experience From A Manchester Based Prospective Study
  1. AM Schofield1,
  2. R McMahon2,
  3. A Sukthankar3,
  4. M Desai4,
  5. J Hill5,
  6. J Patnick6,
  7. EJ Crosbie1,
  8. HC Kitchener1
  1. 1Institute of Cancer Sciences, University of Manchester, Manchester, UK
  2. 2Histopathology, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
  3. 3Manchester Centre for Sexual Health, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
  4. 4Cytolpathology, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
  5. 5Colorectal Surgery, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
  6. 6NHS Cancer Screening Programmes, Public Health England, Sheffield, UK

Abstract

Introduction The UK National Screening Committee has suggested that screening for anal intraepithelial neoplasia (AIN) in populations at high-risk of anal squamous cell carcinoma may be of benefit, but that further information is needed. In these groups the risk of developing anal cancer is increased up-to 100-fold.

Methods ANALOGY is an ongoing prospective cohort study addressing the feasibility and acceptability of anal screening in high-risk groups, based on liquid based cytology (LBC), HPV testing and high-resolution anoscopy (HRA). High-risk patients aged over 25 with no previous history of anal pre-cancer or cancer who are HIV+ men who have sex with men (MSM), HIV- MSM, HIV+ women with a gynaecological neoplasia history or transplant recipients who are 2-years post-procedure were all recruited. All participants had baseline LBC, HPV typing and HRA at recruitment and at 6-months, with a diagnostic biopsy being taken for participants with an abnormal HRA, referral for colorectal opinion was sought in high-grade AIN (HGAIN 3) on biopsy or HSIL on LBC. Data are presented for participants recruited from March 2013.

Results To date, 173 participants have baseline data;78 HIV+ and 25 HIV- MSM, 4 HIV+ women, 42 male and 24 female transplant recipients. Overall 65.8% (114/173) were HPV positive of whom 34.2% (39/114) were HPV 16 positive (30 HIV+ MSM, 7 HIV- MSM, 1 male and 1 female transplant recipients). Abnormal cytology was found in 28.3% (49/173). Abnormal HRA requiring a biopsy was found in 43.3% (75/173) of patients, in HIV+ MSM this proportion was 61.5% (48/78), including 20 high-grade AIN (HGAIN 2 or 3) and one invasive cancer. This constitutes a prevalence of high-grade disease of 26.9% (21/78), 4% (1/25) and 12.5% (3/24) for HIV+, HIV- MSM and renal transplant women respectively. Colorectal referral for HGAIN diagnosed at first visit was required in 7.5% (13/173) of patients, 69.2% (9/13) were HIV+ MSM, 23.1% (3/13) and 7.7% (1/13) were HIV- MSM and a renal transplant woman respectively.

Conclusion Early experience of anal screening in high-risk groups suggests that it is both acceptable and feasible. Colorectal referral for assessment of HGAIN was more frequent in HIV+ MSM than other high-risk groups. These prevalence data are similar to a recently published meta-analysis.

Disclosure of Interest None Declared.

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.