ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2023
Shared Decision-Making Concerning Anal Cancer Screening in Persons With Human Immunodeficiency Virus.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 9 citations in OpenAlex.
- Cancer Screening Behaviors among People with HIV in the United States and the Role of Multi-Level Social and Economic Factors: A Systematic Review.Current epidemiology reports · 2026Article
- Strengthening anal cancer prevention in people with HIV without immediate HRA access-correspondence.Annals of medicine and surgery (2012) · 2025Article
- National Analysis of More Than 48,000 Veterans With HIV Demonstrates CD4/CD8 Ratio as a Risk Marker for Anal Intraepithelial Lesions and Anal Cancer.Diseases of the colon and rectum · 2025Article
- Machine learning-based prediction of mortality risk in AIDS patients with comorbid common AIDS-related diseases or symptoms.Frontiers in public health · 2025Article
- Prevalence of anal high-risk human papillomavirus (HR-HPV) types in people living with HIV and a history of cancer.HIV medicine · 2024Article
- Clinical Predictors and Outcomes of Invasive Anal Cancer for People With HIV in an Inception Cohort.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Article
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4 authors at 1 institution in 1 country.
Funding
Abstract
backgroundAnal high-grade squamous intraepithelial lesion (aHSIL) is the immediate precursor of anal cancer. Anal cytology is a recommended screening test to identify aHSIL among people with human immunodeficiency virus (HIV; PWH). Heterogeneity of risk for invasive anal cancer among PWH suggests the value of a shared decision-making framework regarding screening.
methodsUsing a longitudinal HIV cohort with a comprehensive anal cancer screening program, we estimated the adjusted probabilities of having aHSIL on the first anal cytology. We used logistic regression models with inverse probability weighting to account for differential screening in the cohort and to construct a predicted probability nomogram for aHSIL. Sensitivity analysis was performed to estimate aHSIL prevalence corrected for misclassification bias.
resultsOf 8139 PWH under care between 2007 and 2020, 4105 (49.8%) underwent at least 1 anal cytology test. First-time cytology aHSIL was present in 502 (12.2%) PWH. The adjusted probability of having aHSIL varied from 5% to 18% depending on patient characteristics. Prespecified factors in the aHSIL prediction model included nadir CD4 cell count, ethnicity, race, age, sex, gender identity, and HIV risk factors. The ability of the model to discriminate cytological aHSIL was modest, with an area under the curve of 0.63 (95% confidence interval, .60-.65).
conclusionsPWH are at increased risk for aHSIL and invasive anal cancer. Risk, however, varies by patient characteristics. Individual risk factor profiles predictive of aHSIL can be modeled and operationalized as nomograms to facilitate shared decision-making conversations concerning anal cancer screening.
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