{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T04:12:31Z","timestamp":1790741551921,"version":"4.1.0"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100009139","name":"the German Center for Infection Research","doi-asserted-by":"crossref","award":["TTU HIV 04.817 , TTU HIV 04.819, TI 07.012_002"],"award-info":[{"award-number":["TTU HIV 04.817 , TTU HIV 04.819, TI 07.012_002"]}],"id":[{"id":"10.13039\/100009139","id-type":"DOI","asserted-by":"crossref"}]},{"name":"the Bavarian Gender Equality Grant"},{"name":"the Else-Kr\u00f6ner-Fresenius Stiftung","award":["EKFS, 2021_EKEA.25"],"award-info":[{"award-number":["EKFS, 2021_EKEA.25"]}]},{"name":"Klinikum der Universit\u00e4t M\u00fcnchen"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Infection"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Anal carcinoma (AC) incidence in people with HIV (PWH) is increasing. Guideline-recommended anal-cytology screening facilitates early treatment of precancerous lesions. Data on real-world adherence to screening- and follow-up (F\/U)-recommendations remain limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed routine anal-cytology screening in PWH at a German university hospital-clinic (2017\u20132023), including frequency of findings, F\/U, and final diagnoses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study-population included 434 persons with 936 anal-cytology results, representing 25% of person-time of F\/U at our clinic. Median age was 55 years, female\/male ratio was 5\/429, 310 (71%) were MSM. Median CD4-nadir was 242\/\u00b5l, in 97% viral load was suppressed, 47% were currently smoking.<\/jats:p>\n                    <jats:p>Of 936 swab-results, 882 (94%) were evaluable; 201 (21%) showed abnormalities. Among these, 60 (30%) were ASC-US, 77 (38%) LSIL, 12 (6%) ASC-H, and 52 (26%) HSIL. High-resolution-anoscopy (HRA), recommended for the 64 ASC-H\/HSIL-cases, was performed in 7 (11%), identifying 1 AIN2. In 46\/64 (72%) proctoscopy identified 1 AC and 3 cases each of AIN2\/AIN3. Eleven persons (17%) refused F\/U. Thus, 8\/64 (12.5%) suspicious cytology findings were histopathologically confirmed. During the study period, 4 cases of AC were diagnosed in unscreened persons at our clinic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Routine anal-cytology screening in an unsystematically selected cohort of 434 PWH contributing 1,383 person-years of F\/U identified 7 cases of high-grade precancerous lesions and 1 asymptomatic AC. Important challenges included low uptake, limited specificity of cytology, inconsistent adherence to F\/U recommendations, and insufficient availability of HRA. Improved communication of HIV-care-providers with all involved parties will be a key requirement for improving efficiency and outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s15010-026-02748-4","type":"journal-article","created":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T18:11:50Z","timestamp":1772129510000},"page":"1325-1333","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Challenges and limitations of anal cancer and precancer screening among people with HIV in a real-world setting"],"prefix":"10.1007","volume":"54","author":[{"given":"V.","family":"Menzel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Gruener","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Neuf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Sammet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Esser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Roider","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"U.","family":"Seybold","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,26]]},"reference":[{"issue":"1","key":"2748_CR1","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1002\/ijc.33185","volume":"148","author":"GM Clifford","year":"2021","unstructured":"Clifford GM, Georges D, Shiels MS, et al. A meta-analysis of anal cancer incidence by risk group: toward a unified anal cancer risk scale. Int J Cancer. 2021;148(1):38\u201347.","journal-title":"Int J Cancer"},{"issue":"2","key":"2748_CR2","doi-asserted-by":"publisher","first-page":"198","DOI":"10.1016\/S1473-3099(17)30653-9","volume":"18","author":"C Lin","year":"2018","unstructured":"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\u2013206.","journal-title":"Lancet Infect Dis"},{"issue":"5","key":"2748_CR3","doi-asserted-by":"publisher","first-page":"853","DOI":"10.1093\/cid\/ciaa166","volume":"72","author":"IM Poynten","year":"2021","unstructured":"Poynten IM, Jin F, Roberts JM, et al. The natural history of anal high-grade squamous intraepithelial lesions in gay and bisexual men. Clin Infect Dis. 2021;72(5):853\u201361.","journal-title":"Clin Infect Dis"},{"key":"2748_CR4","unstructured":"Krzowska-Firycha J, Lucasb C, Lucasb N, Pietrzyk L. An overview of Human Papillomavirus (HPV) as an etiological factor of the anal cancer. J Infect Public Health 2023; 16(4)."},{"issue":"5","key":"2748_CR5","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1097\/PAP.0000000000000035","volume":"21","author":"KP Maniar","year":"2014","unstructured":"Maniar KP, Nayar R. HPV-related squamous neoplasia of the lower anogenital tract: an update and review of recent guidelines. Adv Anat Pathol. 2014;21(5):341\u201358.","journal-title":"Adv Anat Pathol"},{"issue":"9","key":"2748_CR6","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.70596","volume":"97","author":"A Villoslada","year":"2025","unstructured":"Villoslada A, Rodriguez A, Sorni P, et al. The role of human papillomavirus genotypes on anal squamous intraepithelial lesions among gay, bisexual and other men who have sex with men living with HIV: beyond HPV-16. J Med Virol. 2025;97(9):e70596.","journal-title":"J Med Virol"},{"issue":"9","key":"2748_CR7","doi-asserted-by":"publisher","first-page":"e531","DOI":"10.1016\/S2352-3018(21)00108-9","volume":"8","author":"F Wei","year":"2021","unstructured":"Wei F, Gaisa MM, D\u2019Souza G, et al. Epidemiology of anal human papillomavirus infection and high-grade squamous intraepithelial lesions in 29 900 men according to HIV status, sexuality, and age: a collaborative pooled analysis of 64 studies. Lancet HIV. 2021;8(9):e531\u201343.","journal-title":"Lancet HIV"},{"issue":"11","key":"2748_CR8","doi-asserted-by":"publisher","first-page":"1457","DOI":"10.1097\/QAD.0b013e3281c61201","volume":"21","author":"L Abramowitz","year":"2007","unstructured":"Abramowitz L, Benabderrahmane D, Ravaud P, et al. Anal squamous intraepithelial lesions and condyloma in HIV-infected heterosexual men, homosexual men and women: prevalence and associated factors. AIDS. 2007;21(11):1457\u201365.","journal-title":"AIDS"},{"issue":"7","key":"2748_CR9","doi-asserted-by":"publisher","first-page":"689","DOI":"10.1016\/j.ijmm.2015.08.019","volume":"305","author":"U Wieland","year":"2015","unstructured":"Wieland U, Hellmich M, Wetendorf J, et al. Smoking and anal high-risk human papillomavirus DNA loads in HIV-positive men who have sex with men. Int J Med Microbiol. 2015;305(7):689\u201396.","journal-title":"Int J Med Microbiol"},{"issue":"8","key":"2748_CR10","first-page":"1025","volume":"23","author":"D Chromy","year":"2025","unstructured":"Chromy D, Aigner F, Becker JC, et al. German-Austrian guideline on screening for anal dysplasia and anal carcinoma in people living with HIV. J Dtsch Dermatol Ges. 2025;23(8):1025\u201340.","journal-title":"J Dtsch Dermatol Ges"},{"issue":"24","key":"2748_CR11","doi-asserted-by":"publisher","first-page":"2273","DOI":"10.1056\/NEJMoa2201048","volume":"386","author":"JM Palefsky","year":"2022","unstructured":"Palefsky JM, Lee JY, Jay N, et al. Treatment of anal high-grade squamous intraepithelial lesions to prevent anal cancer. N Engl J Med. 2022;386(24):2273\u201382.","journal-title":"N Engl J Med"},{"issue":"2","key":"2748_CR12","doi-asserted-by":"publisher","first-page":"e97","DOI":"10.1016\/S2352-3018(22)00368-X","volume":"10","author":"RP van der Zee","year":"2023","unstructured":"van der Zee RP, Wit F, Richel O, et al. Effect of the introduction of screening for cancer precursor lesions on anal cancer incidence over time in people living with HIV: a nationwide cohort study. Lancet HIV. 2023;10(2):e97\u2013106.","journal-title":"Lancet HIV"},{"issue":"5","key":"2748_CR13","doi-asserted-by":"publisher","first-page":"1133","DOI":"10.1093\/cid\/ciae541","volume":"80","author":"AC Achhra","year":"2025","unstructured":"Achhra AC, Chan E, Applebaum S, et al. Five-year evaluation of an anal cancer screening program in men who have sex with men with HIV at 2 academic center clinics. Clin Infect Dis. 2025;80(5):1133\u20138.","journal-title":"Clin Infect Dis"},{"issue":"12","key":"2748_CR14","doi-asserted-by":"publisher","first-page":"1302","DOI":"10.1111\/ddg.12726","volume":"13","author":"S Esser","year":"2015","unstructured":"Esser S, Kreuter A, Oette M, et al. German-Austrian guidelines on anal dysplasia and anal cancer in HIV-positive individuals: prevention, diagnosis, and treatment. JDDG: J der Deutschen Dermatologischen Gesellschaft. 2015;13(12):1302\u201319.","journal-title":"JDDG: J der Deutschen Dermatologischen Gesellschaft"},{"key":"2748_CR15","doi-asserted-by":"publisher","first-page":"28","DOI":"10.25259\/CMAS_03_07_2021","volume":"19","author":"MA Pangarkar","year":"2022","unstructured":"Pangarkar MA. The Bethesda System for reporting cervical cytology. Cytojournal. 2022;19:28.","journal-title":"Cytojournal"},{"issue":"4","key":"2748_CR16","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1159\/000502881","volume":"64","author":"A Albuquerque","year":"2020","unstructured":"Albuquerque A. Cytology in anal cancer screening: practical review for clinicians. Acta Cytol. 2020;64(4):281\u20137.","journal-title":"Acta Cytol"},{"issue":"9","key":"2748_CR17","doi-asserted-by":"publisher","first-page":"436","DOI":"10.1089\/apc.2023.0144","volume":"37","author":"CB Sanger","year":"2023","unstructured":"Sanger CB, Kalbfell E, Cherney-Stafford L, Striker R, Alagoz E. A qualitative study of barriers to anal cancer screenings in US veterans living with HIV. AIDS Patient Care STDS. 2023;37(9):436\u201346.","journal-title":"AIDS Patient Care STDS"},{"issue":"4","key":"2748_CR18","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1097\/LGT.0000000000000256","volume":"20","author":"RJ Hillman","year":"2016","unstructured":"Hillman RJ, Cuming T, Darragh T, et al. 2016 IANS International guidelines for practice standards in the detection of anal cancer precursors. J Low Genit Tract Dis. 2016;20(4):283\u201391.","journal-title":"J Low Genit Tract Dis"},{"issue":"10","key":"2748_CR19","doi-asserted-by":"publisher","first-page":"1694","DOI":"10.1002\/ijc.34850","volume":"154","author":"EA Stier","year":"2024","unstructured":"Stier EA, Clarke MA, Deshmukh AA, et al. International Anal Neoplasia Society\u2019s consensus guidelines for anal cancer screening. Int J Cancer. 2024;154(10):1694\u2013702.","journal-title":"Int J Cancer"},{"issue":"13","key":"2748_CR20","doi-asserted-by":"publisher","first-page":"2157","DOI":"10.1097\/QAD.0000000000002948","volume":"35","author":"R Silvera","year":"2021","unstructured":"Silvera R, Martinson T, Gaisa MM, Liu Y, Deshmukh AA, Sigel K. The other side of screening: predictors of treatment and follow-up for anal precancers in a large health system. AIDS. 2021;35(13):2157\u201362.","journal-title":"AIDS"},{"issue":"2","key":"2748_CR21","doi-asserted-by":"publisher","first-page":"390","DOI":"10.1093\/cid\/ciz831","volume":"71","author":"B Revollo","year":"2020","unstructured":"Revollo B, Videla S, Llibre JM, et al. Routine screening of anal cytology in persons with human immunodeficiency virus and the impact on invasive anal cancer: a prospective cohort study. Clin Infect Dis. 2020;71(2):390\u20139.","journal-title":"Clin Infect Dis"},{"key":"2748_CR22","unstructured":"Neuf J, Noe S, Bogner J, Roider J, Seybold U. Preventive care for people with HIV - what biases do we need to overcome? 12th German-Austrian AIDS Conference D\u00d6AK, Abstract 90, March 20\u201322 2025; Vienna, Austria."},{"issue":"8","key":"2748_CR23","doi-asserted-by":"publisher","first-page":"1319","DOI":"10.1093\/jnci\/djae094","volume":"116","author":"SH Rim","year":"2024","unstructured":"Rim SH, Beer L, Saraiya M, Tie Y, Yuan X, Weiser J. Prevalence of anal cytology screening among persons with HIV and lack of access to high-resolution anoscopy at HIV care facilities. J Natl Cancer Inst. 2024;116(8):1319\u201332.","journal-title":"J Natl Cancer Inst"},{"key":"2748_CR24","unstructured":"Gr\u00fcner E, Reiling G, Stirner R, et al. High burden of human papillomavirus infection and persistence in people living wit HIV. 12th German-Austrian AIDS Conference D\u00d6AK, Abstract 153, March 20\u201322 2025; Vienna, Austria."},{"issue":"2","key":"2748_CR25","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1093\/cid\/ciae359","volume":"80","author":"F Gutierrez","year":"2025","unstructured":"Gutierrez F, Lopez L, Galera C, et al. Early detection of cancer and precancerous lesions in persons with HIV through a comprehensive cancer screening protocol. Clin Infect Dis. 2025;80(2):371\u201380.","journal-title":"Clin Infect Dis"},{"issue":"Suppl_2","key":"2748_CR26","doi-asserted-by":"publisher","first-page":"S179","DOI":"10.1093\/cid\/ciac044","volume":"74","author":"LF Barroso","year":"2022","unstructured":"Barroso LF, Stier EA, Hillman R, Palefsky J. Anal cancer screening and prevention: summary of evidence reviewed for the 2021 Centers for disease control and prevention sexually transmitted infection guidelines. Clin Infect Dis. 2022;74(Suppl_2):S179\u201392.","journal-title":"Clin Infect Dis"}],"container-title":["Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s15010-026-02748-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s15010-026-02748-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s15010-026-02748-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T15:45:31Z","timestamp":1782920731000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s15010-026-02748-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,26]]},"references-count":26,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["2748"],"URL":"https:\/\/doi.org\/10.1007\/s15010-026-02748-4","relation":{},"ISSN":["0300-8126","1439-0973"],"issn-type":[{"value":"0300-8126","type":"print"},{"value":"1439-0973","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,26]]},"assertion":[{"value":"5 December 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 February 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 February 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Parts of these data has been presented at D\u00d6AK 2025, Vienna: Menzel V., Esser S., Gr\u00fcner E., Corominas A., Bogner J., Roider J., Seybold U., Anal cytology screening for people with HIV in a real-world setting \u2013 are we making a difference or just wasting time? 12th German-Austrian AIDS Conference D\u00d6AK, Abstract 79, March 20\u201322 2025; Vienna, Austria. Presented by Viktoria Menzel.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Poster Presentation"}}]}}