First author Edward Cachay, MD, professor of medicine at UC San Diego School of Medicine and an infectious disease specialist at UC San Diego Health’s Owen Clinic Diego for people living with HIV.
“Our goal is to develop a model-driven imaging imaging that will assist patients and their physicians in making anal cancer screening decisions based on projected risk profiles. guess.”
A nominal histogram is a mathematical model that calculates the relationships between variables. They are often used in cancer prognosis to predict the probability of an event, such as a positive biopsy, risk of recurrence, or survival rate.
In the new study, Cachay and colleagues studied data from 8,139 HIV-infected people treated at the Owen Clinic between 2007 and 2020. Of that total, less than half underwent at least one test. anal cytology: 65% had abnormal anal cytology results, 12.2% had HSIL. The probability of having adjusted HSIL varies from 5 to 18 percent, depending on patient characteristics and behavioral presentation.
Anal cancer in HIV patients
The highest risk observed was associated with men who have sex with men (14%) and those with CD4 cell counts below 200. (CD4 cells, also known as T cells, are white blood cells that fight infection and play an important role in the immune system.)
However, the authors note that no single patient characteristic was associated with an predicted HSIL risk of less than 8%, highlighting an increased risk of anal cancer in people living with HIV.
Anal cytology is a simple, inexpensive, and uncomplicated component of screening for precursors of anal cancer. When combined with a digital rectal exam, both pre-existing lesions and established cancers can be identified early in people at high risk, says Cachay.
“We have solid evidence from a large randomized controlled trial that rectal treatment of HSIL significantly reduces the risk of progression to invasive cancer. – discussion between HIV-infected patients and physicians on whether or not to screen.
“Our nomogram informs one component of the screening discussion: the risk of having an immediate precursor of invasive cancer, HSIL. It estimates quantitative risk based on established patient characteristics. Our paper also highlights the limits of uncertainty associated with risk and discusses other important issues to be included in the general discussion of decision-making involved. to the screening.”