Study demonstrating link between anal cancer and HPV infection published in Obstetrics & Gynecology

Care New EnglandFeb 18 2016

Researchers at Women & Infants Hospital, a Care New England hospital, recently published the results of a study demonstrating a connection between anal cancer and human papillomavirus (HPV) infection.

The study - entitled "Anal Cytology and Human Papillomavirus Genotyping in Women with a History of Lower Genital Tract Neoplasia Compared with Low-Risk Women" - was published in a recent issue of the professional journal Obstetrics & Gynecology.

The publication extends the research of Katina Robison, MD, of the Program in Women's Oncology at Women & Infants. The initial research, presented at the 2014 HPV Conference, indicated an increased likelihood that the two diseases would coexist in some women.

"HPV is associated with anal cancer, which is more common among women. In 2014 alone, there were 7,200 cases of anal cancer noted and 4,500 of them are women. We believe that certain women with a history of an HPV-related genital infection would benefit greatly from anal cancer screening," says Dr. Robison, who is also an assistant professor and co-director of colposcopy at The Warren Alpert Medical School of Brown University.

Anal cancer screening is routinely performed using anal cytology in HIV positive men and women, as well as in men having sex with men. Knowing that anal cancer is five times more likely in women with a history of cervical, vaginal or vulvar cancer, which are all linked to HPV, Dr. Robison wanted to evaluate the feasibility of screening HIV negative women with anal cytology and HPV testing.

The research - conducted from December 2012 to February 2014 - examined 273 women recruited through Women & Infants' outpatient clinics. Anal cytology and HPV genotyping were performed. All women with abnormal anal cytology were referred for high-resolution anoscopy. Biopsies were also conducted at the discretion of the colorectal surgeon.

The 273 women were divided into two groups - the "high-risk group" who had a history of cervical, vaginal or vulvar cancer, and the "low-risk group" who had no history of cancer, dysplasia or abnormal Pap smears. Of those, 40 percent of the high-risk group and 21.7 percent of the low-risk group were found to have abnormal anal cytology. In the high-risk group, 20.8 percent were found to have high-risk HPV, but only 1.2 percent of the low-risk group.