Anal Pap smear

There is no consensus on who should get an anal Pap smear. Some individuals recommend that all men and women who have anal sex should have an anal Pap smear performed regularly.{{cite web

| url = http://www.aidsmeds.com/articles/aids_anal_pap_2042_14727.shtml

| title = Pap Smears for Anal Cancer?

| last = Evans

| first = David

| date = 2008-06-10

| access-date = 2011-06-01

| work = AIDSmeds

| publisher = Smart + Strong

| location = New York

| archive-url = https://web.archive.org/web/20110707094737/http://www.aidsmeds.com/articles/aids_anal_pap_2042_14727.shtml

| archive-date = 7 July 2011

| url-status = dead

}} Some recommend it for all men who have had sex with men,{{cite web

| url = http://std.about.com/od/gettingtested/a/analpap.htm

| title = The Anal Pap Smear: Who, When, & Why

| last = Boskey

| first = Elizabeth

| date = 2010-04-10

| access-date = 2011-06-01

| work = About.com: Sexually Transmitted Diseases (STDs)

| publisher = The New York Times Company

| location = New York

| archive-url= https://web.archive.org/web/20110707075110/http://std.about.com/od/gettingtested/a/analpap.htm| archive-date= 7 July 2011 | url-status= live}} for all individuals with HIV and anal warts, or for all individuals with a history of anal warts. Cost-effectiveness studies have reported conflicting conclusions, due to incomplete understanding of the natural history of anal HPV infection and lack of clarity of the efficacy of interventions.{{cite journal|last1=Howard|first1=Kirsten|title=The cost-effectiveness of screening for anal cancer in men who have sex with men: a systematic review|journal=Sexual Health|date=2012|issue=6|pages=610–619|doi=10.1071/SH12017|pmid=22951072|volume=9}} An informal survey of local infectious-disease doctors in southeast Michigan suggested that few know where to send patients for an anal Pap smear. The procedure is very simple, and can be easily performed in any doctor's office with a little training.{{cite web

| url = http://www.aidsmeds.com/articles/HPV_6806.shtml

| title = Human Papilloma Virus (HPV, genital warts, anal/cervical dysplasia/cancer

| work = AIDSmeds

| date = 2011-01-06

| access-date = 2011-06-01

| publisher = Smart + Strong

}}

Typically, a small brush or Dacron-tipped rod is inserted into the anus. The cells collected by the brush or rod are smeared onto a glass slide, air-dried, and sealed with an adhesive. Many medical offices prefer to suspend the collected cells in a liquid medium; the suspension is then processed in a laboratory before being plated on a glass slide. The specimen is sent to a pathologist, indicating the source of the smear (anal canal). The liquid in which the cells are suspended can also be used for HPV typing.{{cite journal|last1=Darragh|first1=Teresa|title=Screening for anal neoplasia: anal cytology – sampling, processing and reporting|journal=Sexual Health|date=2012|volume=5|issue=6|pages=556–561|doi=10.1071/SH12003|pmid=22950982|url=https://zenodo.org/record/896690}}

The procedure is easily performed in a doctor's office, using the same kit as for cervical cancer detection. It can be performed quickly, as a vaginal speculum or anoscope is not required.{{cite web

|url=http://www.hivcouncil.org/AnalPap/Analpap_howto.html

|title=The Anal Pap: a guide for primary care providers

|work=hivcouncil.org

|publisher=New Haven HIV Consumer Council

|location=New Haven, CT

|last=Daskalakis

|first=Demetre

|access-date=2011-06-01

|url-status=dead

|archive-url=https://web.archive.org/web/20110726152012/http://www.hivcouncil.org/AnalPap/Analpap_howto.html

|archive-date=2011-07-26

}}

The sensitivity and specificity of anal Pap smears are lower than those of their cervical counterparts.{{cite journal |vauthors=Roberts JM, Thurloe JK | year = 2012 | title = Comparison of the performance of anal cytology and cervical cytology as screening tests | journal = Sexual Health | volume = 9 | issue = 6| pages = 568–573 | doi = 10.1071/SH11178 | pmid = 22951325 }}

A person might be referred to a colorectal surgeon, an infectious disease doctor, or a physician trained in colposcopy, examination, or biopsy of this region. At a minimum, a digital rectal exam is performed. A proctoscopic exam might follow. Ultimately, a biopsy might be performed, with or without the aid of a colposcope,{{cite book

| chapter-url = http://www.gyncph.dk/procedur/ref/gyn/vulvoscopi_chapter14_eagc.pdf

| title = EAGC Course Book on Colposcopy

| series = European Academy of Gynaecological Cancer (EAGC)

| editor-first = Péter

| editor-last = Bősze

| editor2-last = Luesley

| editor2-first = David M.

| year = 2004

| publisher = Primed-X Press

| isbn = 978-963-00-7356-1

| chapter = Chapter 14: Colposcopy of the vulva, perineum, and anal canal

| last = Kesic

| first = Vesna

| pages = 126–163

| access-date = 2011-06-01

}} a dermatoscope, or high-resolution anoscopy.

{{Refbegin|colwidth=30em}}

• {{Cite journal

| title = Anal dysplasia in men who have sex with men

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| pmid = 12728907

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• {{Cite journal

| title = Anal Squamous Intraepithelial Lesions in HIV-Positive and HIV-Negative Homosexual and Bisexual Men: Prevalence and risk factors

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| title = Virologic, Immunologic, and Clinical Parameters in the Incidence and Progression of Anal Squamous Intraepithelial Lesions in HIV-Positive and HIV-Negative Homosexual Men

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| journal = Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology

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• {{Cite journal

| title = Association of anal dysplasia and human papillomavirus with immunosuppression and HIV infection among homosexual men

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• {{Cite journal

| title = Cost-effectiveness of screening for anal squamous intraepithelial lesions and anal cancer in human immunodeficiency virus–negative homosexual and bisexual men

| url = http://www.amjmed.com/article/S0002-9343%2800%2900349-1/abstract

| display-authors=3

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| journal = The American Journal of Medicine

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| pmid = 10856411

| issn = 0002-9343

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}}

• {{Cite journal

| title = The Clinical Effectiveness and Cost-effectiveness of Screening for Anal Squamous Intraepithelial Lesions in Homosexual and Bisexual HIV-Positive Men

| display-authors=3

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| pmid=10340370

| doi-access = free

}}

{{Refend}}

{{Reflist|colwidth=30em}}

{{Human papillomavirus}}

{{DEFAULTSORT:Anal Pap Smear}}

Category:Papillomavirus-associated diseases

Category:Medical tests

Category:Gastrointestinal cancer