{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T14:33:49Z","timestamp":1783521229820,"version":"3.55.0"},"reference-count":41,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2016,2,24]],"date-time":"2016-02-24T00:00:00Z","timestamp":1456272000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer Cytopathology"],"published-print":{"date-parts":[[2016,6]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Studies regarding the performance of anal cytology in which both the screening test (cytology) and the diagnostic test (high\u2010resolution anoscopy [HRA]) are performed in all members of a screening population are rare. The authors evaluated the performance of liquid\u2010based anal cytology in a cohort of homosexual men in Sydney, New South Wales, Australia.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>The Study of the Prevention of Anal Cancer (SPANC) is a 3\u2010year prospective study of the natural history of anal human papillomavirus infection in homosexual men aged \u226535 years. At baseline, all participants underwent a liquid\u2010based anal cytology test and HRA at the same clinical visit. Biopsies were obtained for histological assessment if lesions suspicious for human papillomavirus infection were visible during HRA. Using any cytological abnormality as the threshold, the sensitivity, specificity, and positive and negative predictive values were calculated against histologically diagnosed high\u2010grade squamous intraepithelial lesions (HSILs).<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Among 617 men recruited, the median age was 49 years (range, 35\u201079 years) and 35.7% were positive for the human immunodeficiency virus. Overall, the sensitivity of cytology was 83.2%, the specificity was 52.6%, the positive predictive value was 45.8%, and the negative predictive value was 86.7%. Specificity improved with increasing age (<jats:italic>P<\/jats:italic> for trend =.041). Sensitivity was significantly higher in men with &gt;1 anal octant of biopsy\u2010confirmed HSIL (92.9% vs 77.7%; <jats:italic>P<\/jats:italic> = .010), and in those who had \u226510 metaplastic cells present on their cytology slides (87.5% vs 70.2%; <jats:italic>P<\/jats:italic> = .007).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Anal cytology was found to have a higher specificity in older men while maintaining sensitivity. Sensitivity was higher among those with more extensive HSILs and men with metaplastic cells present on cytology. <jats:bold><jats:italic>Cancer Cytopathol<\/jats:italic> 2016;124:415\u201324<\/jats:bold>. \u00a9 <jats:italic>2016 American Cancer Society<\/jats:italic>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncy.21702","type":"journal-article","created":{"date-parts":[[2016,2,26]],"date-time":"2016-02-26T03:27:00Z","timestamp":1456457220000},"page":"415-424","source":"Crossref","is-referenced-by-count":44,"title":["The performance of anal cytology as a screening test for anal HSILs in homosexual men"],"prefix":"10.1002","volume":"124","author":[{"given":"Fengyi","family":"Jin","sequence":"first","affiliation":[{"name":"The Kirby Institute University of New South Wales Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew E.","family":"Grulich","sequence":"additional","affiliation":[{"name":"The Kirby Institute University of New South Wales Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I. Mary","family":"Poynten","sequence":"additional","affiliation":[{"name":"The Kirby Institute University of New South Wales Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard J.","family":"Hillman","sequence":"additional","affiliation":[{"name":"Western Sydney Sexual Health Centre Western Sydney Local Health District Parramatta New South Wales Australia"},{"name":"Centre for Infectious Diseases and Microbiology, Westmead Clinical School, University of Sydney Sydney New South Wales Australia"},{"name":"St Vincent's Hospital Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Templeton","sequence":"additional","affiliation":[{"name":"The Kirby Institute University of New South Wales Sydney New South Wales Australia"},{"name":"RPA Sexual Health Sydney Local Health District Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmella L.H.","family":"Law","sequence":"additional","affiliation":[{"name":"St Vincent's Hospital Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annabelle","family":"Farnsworth","sequence":"additional","affiliation":[{"name":"Douglass Hanly Moir Pathology Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne M.","family":"Garland","sequence":"additional","affiliation":[{"name":"Royal Women's Hospital University of Melbourne Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher K.","family":"Fairley","sequence":"additional","affiliation":[{"name":"Melbourne Sexual Health Centre and Central Clinic School Monash University Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer M.","family":"Roberts","sequence":"additional","affiliation":[{"name":"Douglass Hanly Moir Pathology Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"and on behalf of the SPANC Study Team","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,2,24]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.20364"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.23744"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6604871"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6603175"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2011.01.015"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e31817aebfe"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6605756"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2012.44.5486"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir1012"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0000000000000117"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.03.034"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00042560-199704150-00004"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)16674-9"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0215(20000501)86:3<429::AID-IJC20>3.0.CO;2-D"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.aids.0000181012.62385.4a"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1086\/505219"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.21242"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1071\/SH11178"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e328339e592"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/DCR.0b013e31819793d9"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e328333ab8e"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e328359f255"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0078291"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.24188"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-13-946"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4612-2042-8_8"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0b013e31825c31dd"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.5858\/arpa.LGT200570"},{"key":"e_1_2_7_30_1","unstructured":"New York State Department of Public Health AIDS Institute.Clinical Guidelines: Neoplastic Complications of HIV Infection; Section V\u2013Anal Dysplasia and Cancer. Albany NY: New York State Department of Public Health;2007."},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0012284"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1071\/SH12045"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1086\/383574"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-007-0262-4"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0b013e31821d6cb9"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1071\/SH15170"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.20126"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0090-8258(03)00176-8"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djp367"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0b013e3181fb4547"},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(12)70080-3"},{"key":"e_1_2_7_42_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAT.0000000000000246"}],"container-title":["Cancer Cytopathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fcncy.21702","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncy.21702","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T21:32:41Z","timestamp":1760304761000},"score":1,"resource":{"primary":{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/10.1002\/cncy.21702"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,2,24]]},"references-count":41,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2016,6]]}},"alternative-id":["10.1002\/cncy.21702"],"URL":"https:\/\/doi.org\/10.1002\/cncy.21702","archive":["Portico"],"relation":{},"ISSN":["1934-662X","1934-6638"],"issn-type":[{"value":"1934-662X","type":"print"},{"value":"1934-6638","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,2,24]]}}}