SynthesisThe Lancet. Infectious diseases2019
Cervical determinants of anal HPV infection and high-grade anal lesions in women: a collaborative pooled analysis.
Synthesis in The Lancet. Infectious diseases, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 59 papers, 4 of them syntheses that pooled it.
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Who cites it
59 citing papers in PubMed, 4 syntheses or guidelines pooled it, 122 citations in OpenAlex.
- German-Austrian guideline on screening for anal dysplasia and anal carcinoma in people living with HIV.Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG · 2025Guideline
- Emerging Roles of mFrontiers in oncology · 2022Pooled it
- Clinical Practice Guideline: Anal Cancer—Diagnosis, Treatment and Follow-upDeutsches Arzteblatt international · 2021Guideline
- A meta-analysis of anal cancer incidence by risk group: Toward a unified anal cancer risk scale.International journal of cancer · 2021Pooled it
- Design and initial findings of a natural history study of anal HPV and associated lesions among young adult women in Costa Rica.International journal of cancer · 2025Trial
- Assessing the burden of HPV-associated cancers in Brazil: Hospitalization and mortality trends from 2011 to 2019.Human vaccines & immunotherapeutics · 2026Article
- [Update on anal dysplasia and anal cancer].Dermatologie (Heidelberg, Germany) · 2026Review
- Risk stratification and anal cancer screening in immunocompetent women with genital HPV: Value of multicentric HSIL and performance of HPV-based screening.International journal of cancer · 2026Article
- Concurrent cervical and extra cervical HPV-related lesions: an observational study.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Article
- Incidence and burden of anal cancer-time to fight the growing disparities.ESMO gastrointestinal oncology · 2026Review
- An overview of clinical trials in anal cancer 1999-2024.ESMO gastrointestinal oncology · 2026Article
- Quality of Life and Healthcare Experiences of Patients with Anal Cancer: A Mixed-Methods Study.Current oncology (Toronto, Ont.) · 2026Article
- Causative Human Papillomavirus (HPV) Genotypes of Anal Cancers in Australian Cisgender Women.Journal of medical virology · 2026Article
- Review
- Women with HPV-Driven Anal and Genital Disease: Investigating the Patient Cohort in England.Cancers · 2025Article
- Multi-site HPV infection in women with cervical intraepithelial neoplasia: an exploratory analysis.Journal of the Turkish German Gynecological Association · 2025Article
- Anal Cancer Incidence Rates Among Men and Women With and Without HIV in South Africa.Open forum infectious diseases · 2025Article
- Anogenital high-risk HPV prevalence and screening considerations in female transplant recipients: a cross-sectional study.BMC women's health · 2025Article
- Prevalence and incidence of human papilloma virus-related dysplasia of oropharyngeal, cervical, and anal mucosae in Spanish people with HIV.AIDS (London, England) · 2025Observational
- Characteristics of HPV Infection in Women Cervical and Anal with HIV-Infected and the Advances in Epidemiological Research.Infection and drug resistance · 2025Review
Corrections and comments
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Authors and funding
43 authors at 20 institutions in 19 countries.
Funding
Abstract
backgroundCervical cancer screening might contribute to the prevention of anal cancer in women. We aimed to investigate if routine cervical cancer screening results-namely high-risk human papillomavirus (HPV) infection and cytohistopathology-predict anal HPV16 infection, anal high-grade squamous intraepithelial lesions (HSIL) and, hence, anal cancer.
methodsWe did a systematic review of MEDLINE, Embase, and the Cochrane library for studies of cervical determinants of anal HPV and HSIL published up to Aug 31, 2018. We centrally reanalysed individual-level data from 13 427 women with paired cervical and anal samples from 36 studies. We compared anal high-risk HPV prevalence by HIV status, cervical high-risk HPV, cervical cytohistopathology, age, and their combinations, using prevalence ratios (PR) and 95% CIs. Among 3255 women with anal cytohistopathology results, PRs were similarly calculated for all anal HSIL and HPV16-positive anal HSIL.
findingsCervical and anal HPV infections were highly correlated. In HIV-negative women, anal HPV16 prevalence was 41% (447/1097) in cervical HPV16-positive versus 2% (214/8663) in cervical HPV16-negative women (PR 16·5, 95% CI 14·2-19·2, p<0·0001); these values were 46% (125/273) versus 11% (272/2588) in HIV-positive women (4·4, 3·7-5·3, p<0·0001). Anal HPV16 was also associated with cervical cytohistopathology, with a prevalence of 44% [101/228] for cervical cancer in HIV-negative women (PR vs normal cytology 14·1, 11·1-17·9, p<0·0001). Anal HSIL was associated with cervical high-risk HPV, both in HIV-negative women (from 2% [11/527] in cervical high-risk HPV-negative women up to 24% [33/138] in cervical HPV16-positive women; PR 12·9, 95% CI 6·7-24·8, p<0·0001) and HIV-positive women (from 8% [84/1094] to 17% [31/186]; 2·3, 1·6-3·4, p<0·0001). Anal HSIL was also associated with cervical cytohistopathology, both in HIV-negative women (from 1% [5/498] in normal cytology up to 22% [59/273] in cervical HSIL; PR 23·1, 9·4-57·0, p<0·0001) and HIV-positive women (from 7% [105/1421] to 25% [25/101]; 3·6, 2·5-5·3, p<0·0001). Prevalence of HPV16-positive anal HSIL was 23-25% in cervical HPV16-positive women older than 45 years (5/20 in HIV-negative women, 12/52 in HIV-positive women).
interpretationHPV-based cervical cancer screening programmes might help to stratify anal cancer risk, irrespective of HIV status. For targeted secondary anal cancer prevention in high-risk groups, HIV-negative women with cervical HPV16, especially those older than 45 years, have a similar anal cancer risk profile to that of HIV-positive women.
fundingInternational Agency for Research on Cancer.
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