Evaluation of an Anal Dysplasia Screening Program
Author Information
Author(s): Mathews Christopher, Caperna Joseph, Cachay Edward R., Cosman Bard
Primary Institution: University of California, San Diego
Hypothesis
Screening-prompted early surgical intervention for invasive anal cancer would reduce the incidence of cases requiring treatment with chemoradiation.
Conclusion
The overall incidence rate of invasive anal cancer did not decline in the screening era and was higher than previous estimates for HIV cohorts.
Supporting Evidence
- 28 cases of invasive anal cancer were observed during the study period.
- The incidence rates of invasive anal cancer were 199 and 216 per 100,000 person-years before and after screening, respectively.
- Screening coverage was 73% of the target population.
- The median time from first abnormal cytology to first high resolution anoscopy was 258 days.
- The proportion of patients requiring chemoradiation decreased from 90.9% to 70.6%.
Takeaway
This study looked at how well a screening program for anal cancer worked in HIV patients, finding that the number of cancer cases didn't go down after starting the program.
Methodology
The study analyzed incidence rates and case survival of invasive anal cancer before and after the implementation of a screening program, using patient data from the UCSD Owen Clinic.
Potential Biases
Possible selection bias in offering and accepting screening and overdiagnosis bias.
Limitations
Potential biases in estimating incidence rates, incomplete case ascertainment, and limited follow-up duration.
Participant Demographics
Patients under care for HIV infection at UCSD Owen Clinic between 1995-2005.
Statistical Information
P-Value
0.36
Confidence Interval
95% CI: 0.48 – 2.56
Statistical Significance
p=0.025
Digital Object Identifier (DOI)
Want to read the original?
Access the complete publication on the publisher's website