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Concurrent Anal Human Papillomavirus and Abnormal Anal Cytology in Women With Known Cervical Dysplasia

Lammé, Jacqueline MD; Pattaratornkosohn, Tina MD; Mercado-Abadie, Joselyn MD; Alkhas, Addie MD; Robinson, Allison MD; Lanneau, Grainger MD

doi: 10.1097/AOG.0000000000000370
Contents: Original Research

OBJECTIVE: To evaluate the relationship between anal human papillomavirus (HPV) and dysplasia in women with HPV+-related cervical abnormalities.

METHODS: A prospective cohort study was performed on patients referred to the dysplasia clinic for atypical squamous cells of undetermined significance with HPV, atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesions, low-grade squamous intraepithelial lesions, or high-grade squamous intraepithelial lesions. Exclusion criteria include age younger than 21 years, pregnancy, atypical glandular cells on cytology, or prior total hysterectomy. All patients underwent standard colposcopy with possible biopsy and cervical HPV testing as well as anal swab testing for anal HPV and anal cytology. Patients with abnormal anal cytology were referred to colorectal surgery. Histology was not validated in this study.

RESULTS: One hundred ninety-six patients were evaluable. The prevalence of anal HPV was 32.5%. The prevalence of abnormal anal cytology was 17.6%. Women with high-risk cervical HPV were more likely to have high-risk anal HPV (odds ratio [OR] 3.6, 95% confidence interval [CI] 1.19–10.77, P<.024). Women with high-risk anal HPV were more likely to have abnormal anal cytology (OR 6.5, 95% CI 2.74–15.6, P<.001).

CONCLUSION: High-risk cervical HPV is associated with high-risk anal HPV and abnormal anal cytology.


Women with known cervical dysplasia have a 32.5% (95% confidence interval 0.26–0.40) incidence of high-risk anal human papillomavirus and a 17.6% (95% confidence interval 0.122–0.24) incidence of concurrent abnormal anal cytology.

Departments of Obstetrics and Gynecology and Colorectal Surgery, Naval Medical Center, San Diego, California.

Corresponding author: Jacqueline Lammé, MD, Department of Obstetrics Gynecology, Naval Medical Center, San Diego, 34800 Bob Wilson Drive, San Diego, CA 92134; e-mail:

Supported by Admiral's Research Grant.

The views expressed in this article are those of the authors and do not reflect the official policy or position of the Department of the Navy, Department of Defense, or the U.S. Government.

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2014 by The American College of Obstetricians and Gynecologists.