Re:The role of cytology (Pap tests) and human papillomavirus testing in

[Guest guest]

There are a couple of problems when comparing anal and cervical cancer.

First, is that decades of cervical pap smears have provided tons of data,

showing the time that disease progression requires from atypia to invasive

cancer, we just don't have the same data for the anus. While it might seem

logically evident that rates would be the same, this is unclear. In other sites

with similar cells and architecture, like the mouth, disease progression is not

analogous to what happens in the cervix.

The second problem is why I'm not a huge fan of anal pap smears. In the

cervix, you're trying to hit a very small target with the pap. It's a tiny ring

of tissue just inside the cervix's opening to the uterus. To find it is easy,

and the tissues don't move around. In the anus, you're trying to find bad

areas, but it's a bit like painting the inside of a wet sock with a tiny paint

brush. It's very easy to miss what you need to see.

JB

[Guest guest]

Is there any alternative to anal pap smears? Everbody cant get anoscopy. Like

the PSA test for prostate cancers, it seems wise to repeat anal pap smears often

and if lesions are consistently detected over a period of time, to do anoscopy.

Often lesions resolve by themselves so over-treating may not be beneficial

because of possible side effects.

>

> There are a couple of problems when comparing anal and cervical cancer.

>

> First, is that decades of cervical pap smears have provided tons of data,

showing the time that disease progression requires from atypia to invasive

cancer, we just don't have the same data for the anus. While it might seem

logically evident that rates would be the same, this is unclear. In other sites

with similar cells and architecture, like the mouth, disease progression is not

analogous to what happens in the cervix.

>

> The second problem is why I'm not a huge fan of anal pap smears. In the

cervix, you're trying to hit a very small target with the pap. It's a tiny ring

of tissue just inside the cervix's opening to the uterus. To find it is easy,

and the tissues don't move around. In the anus, you're trying to find bad

areas, but it's a bit like painting the inside of a wet sock with a tiny paint

brush. It's very easy to miss what you need to see.

>

> JB

>

[Guest guest]

"Is there any alternative to anal pap smears? Everbody cant get anoscopy. Like the PSA test for prostate cancers, it seems wise to repeat anal pap smears often and if lesions are consistently detected over a period of time, to do anoscopy. Often lesions resolve by themselves so over-treating may not be beneficial because of possible side effects."There probably is not much of an alternative. Fact is, this is a new area of testing. With luck, we will find that most lesions are detected. It's certainly better than doing nothing. JB