BMJ  2006;332:237 (28 January), doi:10.1136/bmj.332.7535.237-a

Letter

When to test women for human papillomavirus

Take this opportunity to screen for anal cancer too

The first 150 words of the full text of this article appear below.

Editor—The impact of screening for human papillomavirus (HPV) on the rates of cervical intraepithelial neoplasia is topical.1 The introduction of routine cytological screening has reduced the incidence of cervical cancer.

Despite obvious similarities, anal cancer has not been given the same level of attention. There are no guidelines regarding screening. The incidence of anal cancer has increased by almost 40% in women.2 A 26% genotypic concordance exists among concurrent HPV infections of the cervical and anal canals, indicating a common source of infection, such as vaginal and anal intercourse with the same infected partner(s).3 Women with cervical infection have three times the risk of anal infection, and up to 13% will be infected at both sites.3 In the anus, however, non-oncogenic strains predominate. This may explain the lower prevalence of anal compared with cervical cancers.

This, however, does not detract from the fact that young healthy women, infected with HPV . . . [Full text of this article]

Awori J Hayanga, general surgery resident

University of Michigan Health Systems jhayanga@med.umich.edu


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Relevant Article

Lifetime effects, costs, and cost effectiveness of testing for human papillomavirus to manage low grade cytological abnormalities: results of the NHS pilot studies
Rosa Legood, Alastair Gray, Jane Wolstenholme, and Sue Moss
BMJ 2006 332: 79-85. [Abstract] [Full Text] [PDF]

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