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Anal cancer incidence is elevated among HIV-infected individuals, especially men who have sex with men (MSM). However, no national guidelines exist for anal cancer screening or treatment of precancerous anal lesions, in part because data are lacking on progression of anal intraepithelial neoplasia (AIN) to anal cancer. To explore this issue, researchers in Australia reviewed the records of 574 patients (95% MSM, 73% HIV-infected) who underwent anal Pap smears or high-resolution anoscopy between 2004 and 2011. Patients with a history of anal cancer were excluded.
During follow-up (median duration, 1.1 years), incidence of progression from lower-grade dysplasia or absence of dysplasia to AIN3 was 8.1 per 100 person-years; incidence was higher …