{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T11:19:41Z","timestamp":1788779981082,"version":"build-2803163510"},"reference-count":17,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2024,11,4]],"date-time":"2024-11-04T00:00:00Z","timestamp":1730678400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,6,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Guidelines recommend annual anal cytology-based squamous cell carcinoma of anus (SCCA) screening for men who have sex with men with HIV aged \u226535 years (eligible population). The recommended threshold for high-resolution anoscopy (HRA) depends on its availability: low-threshold (any abnormal cytology) if availability is high and high-threshold (high-grade squamous intraepithelial lesion [HSIL] on cytology) if availability is low.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This was a retrospective chart review (2018\u20132022) at academic HIV clinics. We evaluated (1) 5-year uptake of cytology-based SCCA screening in the eligible population and (2) estimated HSIL detection rate based on our current low-threshold criteria, and if high-threshold criteria were used for HRA referral.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 432 eligible individuals, only 219 (50.7%) had at least 1 and only 113 (26%) had &amp;gt;1 SCCA screening tests in a median follow-up of 4 years. Seventy-four (17.1%) individuals had at least 1 abnormal anal cytology during follow-up, of whom 56 (75.6%) underwent HRA. Increasing age (\u226557 years) and history of smoking negatively correlated with ever receiving screening. Anal cytology (365 tests in 206 individuals) showed 17.5% \u201cunsatisfactory\u201d and 26.8% with any abnormal cytology (zero with HSIL) triggering HRA referral. Only 34 individuals (7.8% of screening eligible) were ever detected with HSIL. Strictly using high-threshold criteria for HRA referral would have led to no HRA or HSIL detection.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>We noted poor uptake of screening over time, particularly in older age groups. Importantly, anal cytology performed poorly as a triage test for HRA referral, with high rates of \u201cunsatisfactory\u201d samples and low sensitivity for detecting HSIL.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciae541","type":"journal-article","created":{"date-parts":[[2024,11,4]],"date-time":"2024-11-04T08:46:37Z","timestamp":1730709997000},"page":"1133-1138","source":"Crossref","is-referenced-by-count":7,"title":["Five-Year Evaluation of an Anal Cancer Screening Program in Men Who Have Sex With Men With HIV at 2 Academic Center Clinics"],"prefix":"10.1093","volume":"80","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-8954-345X","authenticated-orcid":false,"given":"Amit C","family":"Achhra","sequence":"first","affiliation":[{"name":"Section of Infectious Diseases, Department of Medicine, Yale School of Medicine , New Haven, Connecticut 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