Systematic reviewGynecologyPrevalence of anal human papillomavirus infection and anal HPV-related disorders in women: a systematic review
Section snippets
Objective
The aim of this paper is to systematically review and to summarize the findings of publications addressing the epidemiology of anal HPV infection, anal neoplasia, and anal cancer in women.
Methods
We performed a systematic review for publications of anal HPV infection, anal histological and cytological abnormalities in women, and anal cancer in women published from January 1997 to Sept. 30, 2013. Because the publications evaluating HPV-related disease were so heterogeneous (different methodologies for
Study characteristics
A total of 60 publications were included in the review. Many of the publications were conducted in women with specific risk factors for anal cancer. Of the anal HPV prevalence publications, 10 publications specified that the population included only HIV-positive women.
Among the publications that did not specify HIV infection, 6 publications were conducted in women with a history of abnormal cervical cytology or intraepithelial neoplasia (IN) 1 or greater of the lower genital tract, 1
Results of anal cytology and histology in women
Table 3, Table 4 summarize publications that evaluated abnormal anal cytology and/or histology in women. Ten publications reported results for only women living with HIV,11, 12, 14, 15, 32, 33, 34, 35, 36, 37 3 publications reported comparative results for both HIV-positive and HIV-negative women.10, 13, 38 Twelve publications evaluated study cohorts of women with abnormal cervical cytology or IN1+ of the lower genital tract. Six of these 12 publications included a small number of HIV-positive
Main findings
Our systematic review of the literature revealed that anal HPV infection in women is prevalent in general and comparable with rates of cervical HPV infection. In particular, HIV-positive women and women with HPV-related pathology of the lower genital tract were found to have high rates of HR HPV infection, high rates of high-grade AIN 2 or greater on biopsy, and elevated rates of anal cancer. Of note, few longitudinal publications evaluating anal HR HPV infection and AIN 2 or greater on women
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This study was supported by National Institutes of Health–funded program grant R01 CA163103; the Center for Innovations in Quality, Effectiveness, and Safety (Center for Innovation no. 13-413); the Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX; and National Institutes of Health–funded AIDS Malignancy Consortium grant U01 CA121947.
The authors report no conflict of interest.