{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T16:09:43Z","timestamp":1778861383650,"version":"3.51.4"},"reference-count":31,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,6,26]],"date-time":"2023-06-26T00:00:00Z","timestamp":1687737600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Cytopathology"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Given the disproportionately elevated anal cancer risk in high\u2010risk populations, it is important to assess the performance of commonly used anal cancer screening tools to improve the effectiveness of detection and treatment methods. This study evaluates 1) the concordance between anal cytology and histology results and 2) the performance of cytology and high\u2010risk human papillomavirus (HR\u2010HPV) genotyping as screening tools for detecting histologically confirmed anal high\u2010grade squamous intraepithelial lesions (HSIL).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data from the Anal Neoplasia Clinic in Puerto Rico (2014\u20132021; <jats:italic>n<\/jats:italic> = 466) was used. The clinical performance of anal cytology and HR\u2010HPV genotyping to detect HSIL was compared to the gold standard: high\u2010resolution anoscopy\u2010guided biopsy. Sensitivity, specificity, positive predictive value, negative predictive value, and \u03ba coefficients were calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 66.95% of the patients were men, 74.0% were people living with HIV, 76.2% had anal HR\u2010HPV infection, and 40.34% had histologically confirmed anal HSIL. The weighted \u03ba statistic between the tests (cytology and histology) was 0.25 (<jats:italic>p<\/jats:italic> &lt; .001). The sensitivity and specificity of cytology alone to detect anal HSIL were 84.3% (95% confidence interval [CI], 78.3%\u201389.1%) and 36.0% (95% CI, 30.3%\u201342.0%), respectively. Anal HR\u2010HPV genotyping had higher sensitivity (92.2%; 95% CI, 87.4%\u201395.6%) and similar specificity (34.8%; 95% CI, 29.2%\u201340.7%) compared to cytology. The two tests combined (positive results following cytology or HR\u2010HPV test) improved sensitivity to detect anal HSIL (97.9%; 95% CI, 94.8%\u201399.4%), but specificity was compromised (19.2%; 95% CI, 14.7%\u201324.4%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Although HR\u2010HPV genotyping improved the detection of anal HSIL, HR\u2010HPV testing had lower specificity than anal cytology alone.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncy.22738","type":"journal-article","created":{"date-parts":[[2023,6,26]],"date-time":"2023-06-26T07:25:58Z","timestamp":1687764358000},"page":"655-664","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Evaluating the performance of anal cytology and high\u2010risk HPV genotyping for detecting anal HSIL in a clinic\u2010based sample of people living with and without HIV in Puerto Rico"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8024-1346","authenticated-orcid":false,"given":"Jeslie M.","family":"Ramos\u2010Cartagena","sequence":"first","affiliation":[{"name":"University of Puerto Rico Comprehensive Cancer Center  San Juan Puerto Rico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kandyce","family":"Keller","sequence":"additional","affiliation":[{"name":"University of Michigan  Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Humberto M.","family":"Guiot","sequence":"additional","affiliation":[{"name":"University of Puerto Rico Comprehensive Cancer Center  San Juan Puerto Rico"},{"name":"School of Medicine University of Puerto Rico Medical Sciences Campus  San Juan Puerto Rico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"University of Puerto Rico Comprehensive Cancer Center  San Juan Puerto Rico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vivian","family":"Col\u00f3n\u2010L\u00f3pez","sequence":"additional","affiliation":[{"name":"University of Puerto Rico Comprehensive Cancer Center  San Juan Puerto Rico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashish A.","family":"Deshmukh","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences College of Medicine Medical University of South Carolina  Charleston South Carolina USA"},{"name":"Hollings Cancer Center Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erick L.","family":"Su\u00e1rez","sequence":"additional","affiliation":[{"name":"University of Puerto Rico Comprehensive Cancer Center  San Juan Puerto Rico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maribel","family":"Tirado\u2010G\u00f3mez","sequence":"additional","affiliation":[{"name":"University of Puerto Rico Comprehensive Cancer Center  San Juan Puerto Rico"},{"name":"School of Medicine University of Puerto Rico Medical Sciences Campus  San Juan Puerto Rico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana P.","family":"Ortiz","sequence":"additional","affiliation":[{"name":"University of Puerto Rico Comprehensive Cancer Center  San Juan Puerto Rico"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,6,26]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djz219"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1200\/go.20.00299"},{"key":"e_1_2_8_4_1","unstructured":"National Cancer Institute.Anal Cancer\u2014Cancer Stat Facts. 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