Association between genital intraepithelial lesions and anal squamous intraepithelial lesions in HIV-negative women

• Published in: American journal of obstetrics and gynecology Vol. 205; no. 2; pp. 115.e1 - 115.e5
• Main Authors: Jacyntho, Cláudia M.A., Giraldo, Paulo C., Horta, Antônio A., Grandelle, Rosana, Gonçalves, Ana K., Fonseca, Thaís, Eleutério, José
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.08.2011; Elsevier
• Subjects: Adolescent; Adult; Age Distribution; anal canal; anus neoplasms; Anus Neoplasms - epidemiology; Anus Neoplasms - pathology; Biological and medical sciences; Biopsy, Needle; Brazil - epidemiology; Carcinoma in Situ - epidemiology; Carcinoma in Situ - pathology; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - surgery; cervical intraepithelial neoplasia; colposcopy; Colposcopy - methods; Comorbidity; Confidence Intervals; Cross-Sectional Studies; Female; Follow-Up Studies; Gastroenterology. Liver. Pancreas. Abdomen; Genital Neoplasms, Female - epidemiology; Genital Neoplasms, Female - pathology; Gynecology. Andrology. Obstetrics; HIV Seronegativity; Human viral diseases; Humans; Immunocompetence; Incidence; Infectious diseases; Logistic Models; Medical sciences; Middle Aged; Multivariate Analysis; Neoplasm Invasiveness - pathology; Neoplasm Staging; Obstetrics and Gynecology; Proctoscopy - methods; Risk Assessment; Sexual Behavior; Socioeconomic Factors; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Tumors; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Young Adult; Brazil; colposcopy; anal canal; anus neoplasms; cervical intraepithelial neoplasia; Human; Immunopathology; Premalignant lesion; Gynecology; Genital system; Retroviridae; AIDS; Immune deficiency; Lentivirus; Obstetrics; Infection; Virus; Anal squamous intraepithelial lesion; Viral disease; Digestive diseases; Intestinal disease; Female; Human immunodeficiency virus; Woman; Intraepithelial neoplasia; Anorectal disease
• ISSN: 0002-9378; 1097-6868; 1097-6868
• DOI: 10.1016/j.ajog.2011.03.011

The objective of the study was to evaluate the risk of anal squamous intraepithelial lesions (ASILs) in immunocompetent women with genital squamous intraepithelial lesions (GSILs). This was a cross-sectional study that included 260 immunocompetent women divided into 2 study groups: 1 group included 184 women diagnosed with GSIL by genital colposcopy and biopsy, and the other included 76 controls. All subjects were submitted to anoscopy followed by a biopsy if pertinent. Of 184 GSIL women, 32 (17.4%) had ASIL ( P < .001). The risk of ASIL was 13.1 times greater for GSIL women when there were 3 or 4 genital sites involved. All cases of high-grade ASIL were found in women with cervical GSILs. Among risk factors, anal intercourse without a condom demonstrated an important association with ASIL (prevalence ratio adjusted for age = 2.6). There seems to be a strong association between ASIL and multicentric GSIL. Another factor related to ASIL was the practice of unprotected anal intercourse.