Anal Pap smears: Should we be doing them?

Authors

  • Kimberley Lindsey MS(N), FNP-BC,

    1. Western Carolina University, School of Nursing, MS (N) Program, Cullowhee, North Carolina
    Search for more papers by this author
  • Claire DeCristofaro MD,

    Associate Professor, Corresponding author
    1. Western Carolina University, School of Nursing, MS (N) Program, Cullowhee, North Carolina
      Claire DeCristofaro, MD, Western Carolina University, School of Nursing, MS(N) Porgram AB Tech Enka Nursing Campus, Suite G-33, 1459 Sand Hill Road, Candler, NC 28715.
      Tel: 828-670-8810, ext. 235; Fax: 828-670-8816;
      E-mail: decristofaro@email.wcu.edu
    Search for more papers by this author
  • Janet James MS(N), FNP-BC

    Assistant Professor
    1. Western Carolina University, School of Nursing, MS (N) Program, Cullowhee, North Carolina
    Search for more papers by this author

Claire DeCristofaro, MD, Western Carolina University, School of Nursing, MS(N) Porgram AB Tech Enka Nursing Campus, Suite G-33, 1459 Sand Hill Road, Candler, NC 28715.
Tel: 828-670-8810, ext. 235; Fax: 828-670-8816;
E-mail: decristofaro@email.wcu.edu

Abstract

Purpose: To identify the need to perform anal Papanicolau (Pap) smears for diagnosing histologic changes associated with human papilloma virus (HPV) infection in order to provide early intervention for the prevention of anal cancer. To offer the primary care provider information, based on evidence-based research, about identifying the high-risk patient using risk factors, instructions on performing the anal Pap smear, interpreting the results, and initiating treatment interventions and/or referrals for care. Additionally, the possibility of an HPV vaccine for men will be discussed.

Data Sources: Evidence-based literature, theoretical framework, and peer-reviewed articles.

Conclusions: Performing anal Pap smears is a valuable tool to detect cytologic changes associated with some strains of HPV infection. For persons participating in receptive anal intercourse, this diagnostic procedure provides the opportunity for early detection to guide appropriate follow-up and interventions.

Implications for practice: Appropriate screening can be incorporated easily into a primary care practice. High-risk groups that would benefit from this screening include men who have sex with men, HIV-infected men and women, immunocompromised men and women, women with a history of cervical or vulvar cancer (or high-grade cervical lesions), and women participating in receptive anal intercourse.

Ancillary