{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T01:03:04Z","timestamp":1773709384278,"version":"3.50.1"},"reference-count":33,"publisher":"CSIRO Publishing","issue":"2","license":[{"start":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T00:00:00Z","timestamp":1770595200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Anal cancer can cause several symptoms, such as anal bleeding, pain or lumps. Although high-grade squamous intraepithelial lesions (HSIL) are precursors of anal cancer, scarce information exists regarding its association with anal symptomatology. This study aims to assess anal symptoms and their association between anal squamous intraepithelial lesions and HSIL in a Hispanic high-risk population, as well as predictors of anal symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data from the baseline visit of patients attending the Anal Neoplasia Clinic of the University of Puerto Rico Comprehensive Cancer Center (September 2016\u2013December 2023) was analyzed. Anal cancer screening was performed and the presence of seven self-reported anal symptoms were assessed at the clinical visit. Logistic regression analyses were performed to evaluate the association of anal symptoms with HSIL by HIV status, as well as predictors of anal symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 872 patients, 69.0% were people living with HIV. HSIL prevalence was 41.7%. Prevalence of self-reported anal symptoms was 19.5%; the most common symptoms were bleeding (6.6%), pain or discomfort (5.3%) and lump (4.2%). On multivariable adjusted analysis, HSIL was not associated with having anal symptoms. However, current smoking (OR 1.12, 95% CI 1.04\u20131.20), having hemorrhoids (OR 1.08, 95% CI 1.02\u20131.14) and anal warts (OR 1.15,\u00a095% CI 1.07\u20131.23) were associated with higher odds of anal symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our results suggest that anal symptoms are not good predictors for HSIL, and that smokers and those with benign anal conditions have increased anal symptomatology. These results highlight the importance of systematic anal cancer screening for prevention and early detection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1071\/sh25075","type":"journal-article","created":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T07:26:37Z","timestamp":1770621997000},"source":"Crossref","is-referenced-by-count":0,"title":["Anal symptoms and high-grade squamous intraepithelial lesions in patients from the Anal Neoplasia Clinic of Puerto Rico"],"prefix":"10.1071","volume":"23","author":[{"given":"Maribel","family":"Tirado-G\u00f3mez","sequence":"first","affiliation":[{"name":"ADivision of Cancer Medicine, University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico."},{"name":"BDepartment of Medicine, University of Puerto Rico School of Medicine, Medical Sciences Campus, San Juan, Puerto Rico."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeslie M.","family":"Ramos-Cartagena","sequence":"additional","affiliation":[{"name":"CDivision of Cancer Control and Population Sciences, University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tanialy","family":"Rivera-Santiago","sequence":"additional","affiliation":[{"name":"CDivision of Cancer Control and Population Sciences, University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8325-9074","authenticated-orcid":true,"given":"Darilyn","family":"Rivera-Collazo","sequence":"additional","affiliation":[{"name":"DPennsylvania State University College of Medicine, 500 University Drive, Hershey, PA 17033, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"ADivision of Cancer Medicine, University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1017-9473","authenticated-orcid":true,"given":"Ana P.","family":"Ortiz","sequence":"additional","affiliation":[{"name":"CDivision of Cancer Control and Population Sciences, University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"67","published-online":{"date-parts":[[2026,3,17]]},"reference":[{"issue":"4","key":"2026031620011699100_R1","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1089\/apc.2013.0365","article-title":"Anal cancer trends in Puerto Rico from 1985 to 2005: the potential impact of the AIDS epidemic.","volume":"28","author":"Ortiz","year":"2014","journal-title":"AIDS Patient Care STDS"},{"issue":"7","key":"2026031620011699100_R2","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1200\/GO.20.00299","article-title":"Squamous cell carcinoma of the anus incidence, mortality, and survival among the general population and persons living with HIV in Puerto Rico, 2000-2016.","volume":"7","author":"Ortiz-Ortiz","year":"2021","journal-title":"JCO Glob Oncol"},{"key":"2026031620011699100_R3","unstructured":"Centers for Disease Control and Prevention. 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