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Anal HPV testing may be ineffective as a cancer screening strategy
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Anal human papillomavirus infection is relatively common in healthy women, but its rapid clearance may limit the use of viral testing as a screening tool for cancer.
The association of anal cancer with human papillomavirus (HPV) has been established in several studies. Therefore, researchers conducted a cohort study involving 431 sexually active women in Hawaii. The goal was to determine patterns in the duration and clearance of anal HPV. The researchers conducted interviews and obtained specimens from the cervix and anus of participants at baseline and then at four-month intervals.
There were 414 incidents of anal HPV infections among 215 (50%) of the women. Further evaluation revealed that 58% of these infections cleared during the follow-up period (1.2 years) and that 87% of those that cleared did so in less than a year.
Incident anal HPV infections cleared at a rate of 8.58 per 100 woman-months.
High-risk anal HPV infections cleared at a rate of 9.16 per 100 woman-months. On average, those infections cleared in 150 days.
The clearance rate for low-risk infections was 7.85 per 100 woman-months. Low-risk infections cleared in an average of 224 days.
HPV-16 infections cleared in 132 days and HPV-18 infections cleared in 212 days. The short duration of these infections may reduce the sensitivity of anal HPV testing and make it less cost effective than cervical HPV screening as a tool for cancer detection, according to the researchers.
Clin Infect Dis. 2009;48:536-546.