Prevalence of anal intraepithelial neoplasia in women with genital neoplasia.

BACKGROUND

Anal intraepithelial neoplasia is believed to be a precursor of anal cancer, and it appears to be related to high-risk human papillomavirus. Women with genital neoplasia have been shown to be at increased risk for anal cancer.

OBJECTIVE

The aim of this study is to determine the prevalence of anal intraepithelial neoplasia in women with genital neoplasia.

DESIGN

This is a cross-sectional study.

SETTING

This study took place at Hospital Nossa Senhora da Conceição, Porto Alegre, Brazil, from May 2008 to April 2010.

PATIENTS: Included in the study were 106 immunocompetent women with a histopathological diagnosis of genital neoplasia and 74 women without gynecologic neoplasia.

MAIN OUTCOME MEASURE: All women underwent high-resolution anoscopy with biopsies of acetowhite areas or abnormal vascular features such as punctation and mosaics for histopathological diagnosis of anal intraepithelial neoplasia.

RESULTS

: The overall prevalence of anal intraepithelial neoplasia was 6.6%. In women with genital neoplasia, the prevalence was 10.4% (95% CI, 5.6%-17.3%), whereas the prevalence was 1.4% (95% CI, 0.07%-6.5%) in women without genital neoplasia (P = .016). The prevalence ratio was 7.68 (95% CI, 1.01-58.21).

LIMITATION: Women with normal results on high-resolution anoscopy were not submitted to random biopsies for ethical reasons. Small lesions could be missed, and thus our findings might be underestimated.

CONCLUSION

The prevalence of anal intraepithelial neoplasia is higher in women with genital neoplasia.