Is the Anal Component of the Anogenital HPV-Related Disease Overlooked During the Surveillance of Patients Treated for Cervical Intraepithelial Neoplasia?

Utku Ozgen; Tolga Guler; Derya Kilic; Ali Gokakin; Muhammed Aykota; Ilknur Kaleli; Yeliz Arman Karakaya; Ugur Sungurtekin

doi:10.7759/cureus.44731

Is the Anal Component of the Anogenital HPV-Related Disease Overlooked During the Surveillance of Patients Treated for Cervical Intraepithelial Neoplasia?

Cureus. 2023 Sep 5;15(9):e44731. doi: 10.7759/cureus.44731. eCollection 2023 Sep.

Authors

Utku Ozgen¹, Tolga Guler², Derya Kilic², Ali Gokakin³, Muhammed Aykota⁴, Ilknur Kaleli⁵, Yeliz Arman Karakaya⁶, Ugur Sungurtekin⁴

Affiliations

¹ Surgery, Pamukkale University, Denizli, TUR.
² Obstetrics and Gynecology, Pamukkale University, Denizli, TUR.
³ General Surgery, Lokman Hekim Etlik Private Hospital, Ankara, TUR.
⁴ General Surgery, Pamukkale University, Denizli, TUR.
⁵ Microbiology, Pamukkale University, Denizli, TUR.
⁶ Pathology, Pamukkale University, Denizli, TUR.

Abstract

Aim: To investigate the anal component of the anogenital Human Papillomavirus (HPV) related disease during surveillance of patients treated for cervical intraepithelial neoplasia (CIN).

Methods: Patients were analyzed within two groups according to the histopathological examination of the cervical biopsies: Low-Grade Squamous Intraepithelial Lesion (LSIL) and High-Grade Squamous Intraepithelial Lesion (HSIL) groups. Anal specimens were also collected in the first-year follow-up visit.

Results: All patients had cervical high-risk HPV (HR HPV) infection at admission. At the first-year follow-up, positive HR HPVs were found in 47% of cervical samples. Despite this clearance, the anal HPV infection rate after the first year was 42.5% and 39.6% in LSIL and HSIL groups. Amongst the HSIL group, anal HR HPV positivity was observed in 29.6% of cases without any cervical HPV infection.

Conclusion: A group of women cured of high-grade lesions have ongoing anal HPV infection. It is reasonable to propose that detecting anal HPV could impact the patient's treatment process. Therefore, prospective studies are needed to investigate this group of women's clinical outcomes and define the clearance rate of cervical HPV infection when anal HPV persists.

Keywords: anal cancer; cervical cancer; cervical intraepithelial neoplasia; human papillomavirus; screening.