Prevalence of anal intraepithelial neoplasia in women with genital neoplasia

Dis Colon Rectum. 2011 Apr;54(4):442-5. doi: 10.1007/DCR.0b013e3182061b34.

Abstract

Background: Anal intraepithelial neoplasia is believed to be a precursor of anal cancer, and it appears to be related to high-risk human papillomavirus. Women with genital neoplasia have been shown to be at increased risk for anal cancer.

Objective: The aim of this study is to determine the prevalence of anal intraepithelial neoplasia in women with genital neoplasia.

Design: This is a cross-sectional study.

Setting: This study took place at Hospital Nossa Senhora da Conceição, Porto Alegre, Brazil, from May 2008 to April 2010.

Patients: Included in the study were 106 immunocompetent women with a histopathological diagnosis of genital neoplasia and 74 women without gynecologic neoplasia.

Main outcome measure: All women underwent high-resolution anoscopy with biopsies of acetowhite areas or abnormal vascular features such as punctation and mosaics for histopathological diagnosis of anal intraepithelial neoplasia.

Results: : The overall prevalence of anal intraepithelial neoplasia was 6.6%. In women with genital neoplasia, the prevalence was 10.4% (95% CI, 5.6%-17.3%), whereas the prevalence was 1.4% (95% CI, 0.07%-6.5%) in women without genital neoplasia (P = .016). The prevalence ratio was 7.68 (95% CI, 1.01-58.21).

Limitation: Women with normal results on high-resolution anoscopy were not submitted to random biopsies for ethical reasons. Small lesions could be missed, and thus our findings might be underestimated.

Conclusion: The prevalence of anal intraepithelial neoplasia is higher in women with genital neoplasia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anus Neoplasms / epidemiology*
  • Anus Neoplasms / pathology
  • Biopsy
  • Brazil / epidemiology
  • Carcinoma in Situ / epidemiology*
  • Carcinoma in Situ / pathology
  • Chi-Square Distribution
  • Colposcopy
  • Cross-Sectional Studies
  • Female
  • Humans
  • Prevalence
  • Proctoscopy
  • Statistics, Nonparametric
  • Surveys and Questionnaires
  • Uterine Cervical Dysplasia / epidemiology*
  • Uterine Cervical Dysplasia / pathology
  • Uterine Cervical Neoplasms / epidemiology*
  • Uterine Cervical Neoplasms / pathology