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  1. Article ; Online: How do we prevent anal cancer in people living with HIV?

    Stier, Elizabeth Ann

    The lancet. HIV

    2023  Volume 10, Issue 2, Page(s) e71–e73

    MeSH term(s) Humans ; Male ; HIV Infections/complications ; HIV Infections/drug therapy ; HIV Infections/prevention & control ; Homosexuality, Male ; Anus Neoplasms/epidemiology ; Anus Neoplasms/prevention & control
    Language English
    Publishing date 2023-01-11
    Publishing country Netherlands
    Document type Journal Article ; Comment
    ISSN 2352-3018
    ISSN (online) 2352-3018
    DOI 10.1016/S2352-3018(22)00399-X
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Sexually Transmitted Human Papillomavirus: Update in Epidemiology, Prevention, and Management.

    Plotzker, Rosalyn E / Vaidya, Akanksha / Pokharel, Utsav / Stier, Elizabeth A

    Infectious disease clinics of North America

    2023  Volume 37, Issue 2, Page(s) 289–310

    Abstract: This review presents the epidemiology, pathophysiology, prevention, and management of sexually transmitted human papillomavirus (HPV) and its associated diseases. HPV is the most common sexually transmitted infection worldwide. Prevalence varies ... ...

    Abstract This review presents the epidemiology, pathophysiology, prevention, and management of sexually transmitted human papillomavirus (HPV) and its associated diseases. HPV is the most common sexually transmitted infection worldwide. Prevalence varies regionally. Low-risk strains cause anogenital warts, which can be managed with patient- or provider-applied therapies. High-risk strains cause lower anogenital cancers. Primary and secondary prevention strategies include vaccination and screening for precancerous lesions, respectively. Management of abnormal screening results vary by test result, anatomic site, and individual cancer risk. Approaches include close rescreening, high-resolution visualization with biopsy, and-when biopsy-proven precancer is identified-removal or destruction of the lesion.
    MeSH term(s) Humans ; Female ; Papillomavirus Infections/complications ; Papillomavirus Infections/epidemiology ; Papillomavirus Infections/prevention & control ; Human Papillomavirus Viruses ; Condylomata Acuminata/diagnosis ; Condylomata Acuminata/epidemiology ; Sexual Behavior ; Vaccination ; Papillomavirus Vaccines ; Papillomaviridae/physiology ; Uterine Cervical Neoplasms/prevention & control
    Chemical Substances Papillomavirus Vaccines
    Language English
    Publishing date 2023-04-27
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1077676-x
    ISSN 1557-9824 ; 0891-5520
    ISSN (online) 1557-9824
    ISSN 0891-5520
    DOI 10.1016/j.idc.2023.02.008
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Anal Cancer Screening and Prevention: Summary of Evidence Reviewed for the 2021 Centers for Disease Control and Prevention Sexually Transmitted Infection Guidelines.

    Barroso, Luis F / Stier, Elizabeth A / Hillman, Richard / Palefsky, Joel

    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

    2022  Volume 74, Issue Suppl_2, Page(s) S179–S192

    Abstract: In June 2019 the Centers for Disease Control and Prevention (CDC) convened an advisory group to assist in development of the 2021 CDC sexually transmitted infections (STI) guidelines. The advisory group on anal cancer screening and prevention met to ... ...

    Abstract In June 2019 the Centers for Disease Control and Prevention (CDC) convened an advisory group to assist in development of the 2021 CDC sexually transmitted infections (STI) guidelines. The advisory group on anal cancer screening and prevention met to formulate key questions in this field. The group examined published literature and abstracts to assess evidence and give recommendations for development of the CDC guidelines. This article summarizes key questions, evidence, recommendations, and areas for further research for the screening, diagnosis, and prevention of anal cancer.
    MeSH term(s) Anus Neoplasms/diagnosis ; Anus Neoplasms/prevention & control ; Centers for Disease Control and Prevention, U.S. ; Early Detection of Cancer ; HIV Infections ; Humans ; Papillomavirus Infections/diagnosis ; Papillomavirus Infections/prevention & control ; Sexually Transmitted Diseases/diagnosis ; Sexually Transmitted Diseases/prevention & control ; United States
    Language English
    Publishing date 2022-06-08
    Publishing country United States
    Document type Journal Article ; Research Support, U.S. Gov't, P.H.S.
    ZDB-ID 1099781-7
    ISSN 1537-6591 ; 1058-4838
    ISSN (online) 1537-6591
    ISSN 1058-4838
    DOI 10.1093/cid/ciac044
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Truth or DARE (Digital Anal Rectal Examination): Gynecologist Viewpoints on Anal Cancer Screening.

    Gaydos, Laura M / Blemur, Danielle / Perry, Tahira / Stier, Elizabeth A / Khan, Michelle J / Flowers, Lisa

    Journal of lower genital tract disease

    2023  Volume 27, Issue 4, Page(s) 351–355

    Abstract: Methods: The authors conducted a survey for practicing gynecologists recruited through academic institutions, professional societies, and professional groups on social media resulting in 196 respondents. The survey, fielded between January and June 2022, ...

    Abstract Methods: The authors conducted a survey for practicing gynecologists recruited through academic institutions, professional societies, and professional groups on social media resulting in 196 respondents. The survey, fielded between January and June 2022, included questions on knowledge, attitudes, training, and practices regarding anal cancer prevention (ACP). Descriptive statistics and χ 2 analysis were completed.
    Results: In terms of knowledge regarding ACP, over 80% of respondents identified certain clinical indications for anal cancer screening. However, only 36% respondents selected the 3 correct ACP screening tools. Twenty-seven (13.9%) respondents reported receiving training on ACP in medical school, whereas 50 (25.9%) reported receiving training during residency. Only 21% of respondents reported that they perform anal cytology, and 32% reported that they perform digital anal rectal examinations. One hundred thirty-six respondents (75.56%) affirmed that they needed additional training on ACP to be able to provide this service to their patients, and 95 (53.1%) stated they were extremely likely to participate in ACP training if given the opportunity.
    Conclusion: Although a limited proportion of practicing gynecologists are trained in ACP, there is willingness to participate in training if it were made available and to incorporate ACP into their practices.
    MeSH term(s) Humans ; Early Detection of Cancer ; Gynecologists ; Anus Neoplasms/diagnosis ; Anus Neoplasms/prevention & control ; Internship and Residency ; Social Media
    Language English
    Publishing date 2023-08-16
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2041332-4
    ISSN 1526-0976 ; 1089-2591
    ISSN (online) 1526-0976
    ISSN 1089-2591
    DOI 10.1097/LGT.0000000000000762
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Anal Cancer and Anal Cancer precursors in Women with a History of HPV-Related Dysplasia and Cancer.

    Stier, Elizabeth A / Chiao, Elizabeth Y

    Seminars in colon & rectal surgery

    2017  Volume 28, Issue 2, Page(s) 97–101

    Abstract: The epidemiology of anal cancer in the U.S. has changed over the past 3 decades. During this period the incidence of anal cancer has increased among both men and women. Of note, women with a history of anogenital HPV infection are at higher risk than the ...

    Abstract The epidemiology of anal cancer in the U.S. has changed over the past 3 decades. During this period the incidence of anal cancer has increased among both men and women. Of note, women with a history of anogenital HPV infection are at higher risk than the general population for anal cancer. The increased risk ranged from increased incidence rate ratios ranging from 1.82 to 6.3 in women with a history of cervical cancer, to 4.2-16.4 in women with a history of prior cervical intraepithelial neoplasia 3 (CIN 3). In addition, studies describing screening women with a previous history of anogential HPV infection (including CIN 3) for anal HPV and anal pre-cancers demonstrate that the prevalence of anal HPV is measureable in this population. The prevalence of anal high grade squamous intraepithelial lesions (HSIL) in this population was relatively low, which may have been related to the fact that many of these studies had insufficient samples, and the numbers of patients undergoing HRA remain low. Future studies evaluating anal cancer screening strategies in this high-risk group are needed.
    Language English
    Publishing date 2017-04-26
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1053129-4
    ISSN 1043-1489
    ISSN 1043-1489
    DOI 10.1053/j.scrs.2017.04.008
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Reply.

    Chiao, Elizabeth / Stier, Elizabeth A

    American journal of obstetrics and gynecology

    2016  Volume 214, Issue 3, Page(s) 411–412

    MeSH term(s) Anus Neoplasms/epidemiology ; Carcinoma in Situ/epidemiology ; Carcinoma, Squamous Cell/epidemiology ; Female ; HIV Infections/epidemiology ; Humans ; Papillomavirus Infections/epidemiology ; Proctitis/epidemiology
    Language English
    Publishing date 2016-03
    Publishing country United States
    Document type Comment ; Letter
    ZDB-ID 80016-8
    ISSN 1097-6868 ; 0002-9378
    ISSN (online) 1097-6868
    ISSN 0002-9378
    DOI 10.1016/j.ajog.2015.10.917
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Provider preferences for anal cancer prevention screening: Results of the International Anal Neoplasia Society survey.

    Plotzker, Rosalyn E / Barnell, Gregory M / Wiley, Dorothy J / Stier, Elizabeth A / Jay, Naomi

    Tumour virus research

    2022  Volume 13, Page(s) 200235

    Abstract: Objective: This study explores provider preferences regarding anal cancer screening indications, initiation age, tools, and referral threshold to high resolution anoscopy (HRA).: Methods: International Anal Neoplasia Society affiliates were invited ... ...

    Abstract Objective: This study explores provider preferences regarding anal cancer screening indications, initiation age, tools, and referral threshold to high resolution anoscopy (HRA).
    Methods: International Anal Neoplasia Society affiliates were invited to complete an online survey. Options for initiation age and tools were delineated by sub-groups. HRA referral thresholds separately queried recommendations by patient immune status.
    Results: One hundred forty respondents participated. Although consensus was lacking with regard to specific screening initiation age, more respondents recommended younger initiation ages for men who have sex with men (MSM) living with HIV (LWH) compared with MSM not LWH (p < 0.01). "No age threshold" ranged 44-55% among sub-groups with lower genital tract disease. Cytology and digital anorectal exam (DARE) were the most frequently selected tools for all sub-groups (ranges 77-90% and 74-86%, respectively). HRA was recommended significantly more frequently for MSM LWH (58%) and patients with vulvar cancer (52%) compared to others (p < 0.01). "Any [test] abnormality" was more often selected as indication for HRA for immunocompromised (56%) and immunocompetent (46%) patients than a specific cytology test result (29%, 36% respectively).
    Conclusion: Cytology and DARE were preferred screening tools; screening initiation age and HRA referral threshold showed less consensus. Evidence-based guidelines are needed and may lead to more consistent screening practices.
    MeSH term(s) Anus Neoplasms/diagnosis ; Early Detection of Cancer/methods ; Homosexuality, Male ; Humans ; Male ; Sexual and Gender Minorities ; Surveys and Questionnaires
    Language English
    Publishing date 2022-02-17
    Publishing country Netherlands
    Document type Journal Article
    ISSN 2666-6790
    ISSN (online) 2666-6790
    DOI 10.1016/j.tvr.2022.200235
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Provider preferences for anal cancer prevention screening

    Rosalyn E. Plotzker / Gregory M. Barnell / Dorothy J. Wiley / Elizabeth A. Stier / Naomi Jay

    Tumour Virus Research, Vol 13, Iss , Pp 200235- (2022)

    Results of the International Anal Neoplasia Society survey

    2022  

    Abstract: Objective: This study explores provider preferences regarding anal cancer screening indications, initiation age, tools, and referral threshold to high resolution anoscopy (HRA). Methods: International Anal Neoplasia Society affiliates were invited to ... ...

    Abstract Objective: This study explores provider preferences regarding anal cancer screening indications, initiation age, tools, and referral threshold to high resolution anoscopy (HRA). Methods: International Anal Neoplasia Society affiliates were invited to complete an online survey. Options for initiation age and tools were delineated by sub-groups. HRA referral thresholds separately queried recommendations by patient immune status. Results: One hundred forty respondents participated. Although consensus was lacking with regard to specific screening initiation age, more respondents recommended younger initiation ages for men who have sex with men (MSM) living with HIV (LWH) compared with MSM not LWH (p < 0.01). “No age threshold” ranged 44-55% among sub-groups with lower genital tract disease. Cytology and digital anorectal exam (DARE) were the most frequently selected tools for all sub-groups (ranges 77-90% and 74-86%, respectively). HRA was recommended significantly more frequently for MSM LWH (58%) and patients with vulvar cancer (52%) compared to others (p < 0.01). “Any [test] abnormality” was more often selected as indication for HRA for immunocompromised (56%) and immunocompetent (46%) patients than a specific cytology test result (29%, 36% respectively). Conclusion: Cytology and DARE were preferred screening tools; screening initiation age and HRA referral threshold showed less consensus. Evidence-based guidelines are needed and may lead to more consistent screening practices.
    Keywords Anal cancer ; Anal neoplasm ; Cancer screening ; Healthcare survey ; Preventive medicine ; Neoplasms. Tumors. Oncology. Including cancer and carcinogens ; RC254-282
    Subject code 150
    Language English
    Publishing date 2022-06-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  9. Article ; Online: The Utility of Digital Anal Rectal Examinations in a Public Health Screening Program for Anal Cancer.

    Nyitray, Alan G / D'Souza, Gypsyamber / Stier, Elizabeth A / Clifford, Gary / Chiao, Elizabeth Y

    Journal of lower genital tract disease

    2020  Volume 24, Issue 2, Page(s) 192–196

    Abstract: Objectives: There are no uniform screening recommendations for anal cancer. Medical practice guidelines are now available on the use of Digital Anal Rectal Examinations (DARE) for the detection of anal cancer; however, because screening can result in ... ...

    Abstract Objectives: There are no uniform screening recommendations for anal cancer. Medical practice guidelines are now available on the use of Digital Anal Rectal Examinations (DARE) for the detection of anal cancer; however, because screening can result in more harm than benefit, our objective was to assess the evidence for use of DARE as a public health screening tool.
    Materials and methods: We conducted a current critical appraisal of anal cancer literature using World Health Organization criteria for assessing the potential utility of a public health screening program.
    Results: Digital Anal Rectal Examination satisfies most, but not all, World Health Organization criteria for a public health program that seeks to detect early invasive anal cancer in populations at high risk for anal cancer, most notably HIV-positive men who have sex with men; however, DARE is not appropriate when facilities for treatment are nonexistent. In addition, there are insufficient data on DARE sensitivity and specificity.
    Conclusions: The mildly invasive nature of DARE, limited likelihood of adverse procedure-related events, cost-effectiveness and patient acceptability, as well as wide availability of DARE support consideration of its integration into screening for populations at high risk of anal cancer, especially HIV-positive men who have sex with men.
    MeSH term(s) Anus Neoplasms/diagnosis ; Early Detection of Cancer ; Homosexuality, Male ; Humans ; Male ; Practice Guidelines as Topic ; Risk Factors ; World Health Organization
    Language English
    Publishing date 2020-01-07
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2041332-4
    ISSN 1526-0976 ; 1089-2591
    ISSN (online) 1526-0976
    ISSN 1089-2591
    DOI 10.1097/LGT.0000000000000508
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: A systematic review and meta-analysis of cytology and HPV-related biomarkers for anal cancer screening among different risk groups.

    Clarke, Megan A / Deshmukh, Ashish A / Suk, Ryan / Roberts, Jennifer / Gilson, Richard / Jay, Naomi / Stier, Elizabeth A / Wentzensen, Nicolas

    International journal of cancer

    2022  Volume 151, Issue 11, Page(s) 1889–1901

    Abstract: To inform optimal approaches for detecting anal precancers, we performed a systematic review and meta-analysis of the diagnostic accuracy of anal cancer screening tests in different populations with elevated risk for anal cancer. We conducted a ... ...

    Abstract To inform optimal approaches for detecting anal precancers, we performed a systematic review and meta-analysis of the diagnostic accuracy of anal cancer screening tests in different populations with elevated risk for anal cancer. We conducted a literature search of studies evaluating tests for anal precancer and cancer (anal intraepithelial neoplasia grade 2 or worse, AIN2+) published between January 1, 1997 to September 30, 2021 in PubMed and Embase. Titles and abstracts were screened for inclusion and included articles underwent full-text review, data abstraction and quality assessment. We estimated the prevalence of AIN2+ and calculated summary estimates and 95% confidence intervals (CI) of test positivity, sensitivity and specificity and predictive values of various testing strategies, overall and among population subgroups. A total of 39 articles were included. The prevalence of AIN2+ was 20% (95% CI, 17-29%), and ranged from 22% in men who have sex with men (MSM) living with HIV to 13% in women and 12% in MSM without HIV. The sensitivity and specificity of cytology and HPV testing were 81% and 62% and 92% and 42%, respectively, and 93% and 33%, respectively for cytology and HPV co-testing. AIN2+ risks were similar among those testing positive for cytology, HPV, or co-testing. Limited data on other biomarkers (HPV E6/E7 mRNA and p16/Ki-67 dual stain), suggested higher specificity, but lower sensitivity compared with anal cytology and HPV. Our findings provide important evidence for the development of clinical guidelines using anal cytology and HPV testing for anal cancer screening.
    MeSH term(s) Anus Neoplasms/diagnosis ; Anus Neoplasms/epidemiology ; Early Detection of Cancer ; Female ; HIV Infections ; Homosexuality, Male ; Humans ; Ki-67 Antigen ; Male ; Papillomaviridae/genetics ; Papillomavirus Infections/diagnosis ; Papillomavirus Infections/epidemiology ; RNA, Messenger/genetics ; Sexual and Gender Minorities
    Chemical Substances Ki-67 Antigen ; RNA, Messenger
    Language English
    Publishing date 2022-08-06
    Publishing country United States
    Document type Journal Article ; Meta-Analysis ; Systematic Review ; Research Support, N.I.H., Intramural
    ZDB-ID 218257-9
    ISSN 1097-0215 ; 0020-7136
    ISSN (online) 1097-0215
    ISSN 0020-7136
    DOI 10.1002/ijc.34199
    Database MEDical Literature Analysis and Retrieval System OnLINE

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