Anal Pap smear

Indications {{Anchor|Who Should Get Anal Pap smears?}}

There is no consensus on who should get an anal Pap smear. Some individuals recommend that all men and women who have anal sex should have an anal Pap smear performed regularly.{{cite web | access-date = 2011-06-01 | archive-url = https://web.archive.org/web/20110707094737/http://www.aidsmeds.com/articles/aids_anal_pap_2042_14727.shtml | archive-date = 7 July 2011 | url-status = dead | access-date = 2011-06-01 | archive-url= https://web.archive.org/web/20110707075110/http://std.about.com/od/gettingtested/a/analpap.htm| archive-date= 7 July 2011 | url-status= live}} for all individuals with HIV and anal warts, An informal survey of local infectious-disease doctors in southeast Michigan suggested that few know where to send patients for an anal Pap smear. The procedure is very simple and can be easily performed in any doctor's office with a little training.{{cite web | access-date = 2011-06-01

Procedure{{Anchor|How is it done?}}

Typically, a small brush or Dacron-tipped rod is inserted into the anus. The cells collected by the brush or rod are smeared onto a glass slide, air-dried, and sealed with an adhesive. Many medical offices prefer to suspend the collected cells in a liquid medium; the suspension is then processed in a laboratory before being plated on a glass slide. The specimen is sent to a pathologist, indicating the source of the smear (anal canal). The liquid in which the cells are suspended can also be used for HPV typing.

The procedure is easily performed in a doctor's office, using the same kit as for cervical cancer detection. It can be performed quickly, as a vaginal speculum or anoscope is not required.{{cite web |access-date=2011-06-01 |url-status=dead |archive-url=https://web.archive.org/web/20110726152012/http://www.hivcouncil.org/AnalPap/Analpap_howto.html |archive-date=2011-07-26

Interpreting an anal Pap smear{{Anchor|How to Manage a Positive Anal Pap smear?}}

The sensitivity and specificity of anal Pap smears are lower than those of their cervical counterparts.

A person might be referred to a colorectal surgeon, an infectious disease doctor, or a physician trained in colposcopy, examination, or biopsy of this region. At a minimum, a digital rectal exam is performed. A proctoscopic exam might follow. Ultimately, a biopsy might be performed, with or without the aid of a colposcope,{{cite book | chapter-url = http://www.gyncph.dk/procedur/ref/gyn/vulvoscopi_chapter14_eagc.pdf | editor-first = Péter | editor-last = Bősze | editor2-last = Luesley | editor2-first = David M. | access-date = 2011-06-01 | archive-date = 2020-09-20 | archive-url = https://web.archive.org/web/20200920034654/http://www.gyncph.dk/procedur/ref/gyn/vulvoscopi_chapter14_eagc.pdf | url-status = dead

Bibliography {{Anchor|Additional Readings}}

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References

References

1. (2012). "The epidemiology of anal cancer". Sexual Health.
2. (2012). "The cost-effectiveness of screening for anal cancer in men who have sex with men: a systematic review". Sexual Health.
3. (2012). "Screening for anal neoplasia: anal cytology – sampling, processing and reporting". Sexual Health.
4. (2012). "Comparison of the performance of anal cytology and cervical cytology as screening tests". Sexual Health.