EP571 - High-Risk HPV Testing Does not Accurately Predict Patients for High Resolution Anoscopy Referrals

Sunday, May 10, 2026

2:35 PM - 2:40 PM ET

ePoster Presenter(s)

JC Chen, MD MPH (they/them/theirs)

Resident
Ohio State University
Ohio State University
Columbus, OH, United States

Disclosure information not submitted.

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Author(s)

Michelle Chan, MD (she/her/hers)

General surgery resident
The Ohio State University
The Ohio State University
Columbus, OH, United States

Disclosure information not submitted.
Joy Zhang, MD

General Surgery Resident
The Ohio State University Wexner Medical Center - Columbus, OH
Columbus, OH, United States

All disclosed relationships have been reviewed and managed prior to the start of this activity. Any relevant relationships will be listed below. This individual has no financial relationships to disclose
Melik Kagan Aktas, MD (he/him/his)

Postdoctoral Clinical Research Fellow
The Ohio State University Department of Surgery
The Ohio State University
Columbus, OH, United States

All disclosed relationships have been reviewed and managed prior to the start of this activity. Any relevant relationships will be listed below. This individual has no financial relationships to disclose
SB

Sydney C. Beache, MD, MPHS (she/her/hers)

Fellow
The Ohio State University
The Ohio State University
Columbus, OH, United States

All disclosed relationships have been reviewed and managed prior to the start of this activity. Any relevant relationships will be listed below. This individual has no financial relationships to disclose
Nikita Wadhwani, MD (she/her/hers)

Colon and rectal surgery fellow
The Ohio State University
University of Alabama at Birmingham
Columbus, OH, United States

All disclosed relationships have been reviewed and managed prior to the start of this activity. Any relevant relationships will be listed below. This individual has no financial relationships to disclose
AH

Alan E. Harzman, MD

Professor
The Ohio State University
Columbus, Ohio, United States

Disclosure information not submitted.
Emily Huang, MD, MEd

Associate Professor
The Ohio State University
Ohio State University
Columbus, OH, United States

All disclosed relationships have been reviewed and managed prior to the start of this activity. Any relevant relationships will be listed below. This individual has no financial relationships to disclose
Matthew F. Kalady, MD

Professor, Division Director,
The Ohio State University Wexner Medical Center and James Cancer Center
Ohio State University
Columbus, Ohio, United States

All disclosed relationships have been reviewed and managed prior to the start of this activity. Any relevant relationships will be listed below. This individual has no relevant financial relationships.
Amber L. Traugott, MD (she/her/hers)

Associate Professor
The Ohio State University
The Ohio State University Wexner Medical Center
Columbus, Ohio, United States

Disclosure information not submitted.
Lisa A. Cunningham, MD

Assistant Professor
The Ohio State University
Columbus, Ohio, United States

All disclosed relationships have been reviewed and managed prior to the start of this activity. Any relevant relationships will be listed below. This individual has no financial relationships to disclose
AG

Alessandra Gasior, DO

Associate Professor
The Ohio State University
Columbus, Ohio, United States

Disclosure information not submitted.

Senior Author(s)

Syed Husain, MB.,BS.

Professor of Surgery-Clinical
The Ohio State University
Ohio State University
Columbus, Ohio, United States

All disclosed relationships have been reviewed and managed prior to the start of this activity. Any relevant relationships will be listed below. This individual has no financial relationships to disclose

Purpose/Background: Prior studies suggest high-risk human papillomavirus (HR-HPV) testing may help triage patients with normal or atypical squamous cells of undetermined significant cytology for high-resolution anoscopy (HRA). However, this approach has not undergone rigorous scientific validation and raises concerns about potentially excluding patients who remain at significant risk for high-grade anal dysplasia (HGD) despite being HR-HPV (-). Our primary aim was to critically evaluate the use of HR-HPV status as a triage tool for HRA.

Methods/Interventions: Patients ≥18 years of age who underwent HRA for abnormal anal cytology at a Comprehensive Cancer Center between 2017-2024 were retrospectively reviewed. Low-grade dysplasia (LGD) was defined as biopsy-proven anal intraepithelial neoplasia-1 (AIN-1) and HGD was defined as AIN-2 or 3. Associations between degree of dysplasia and presence of HR-HPV were evaluated with Fisher’s Exact tests and multinomial regression analysis.

Results/Outcomes: There were 300 encounters with known HR-HPV status, of which 171 (57%) were HR-HPV (+) and 129 (43%) were HR-HPV (-). Although presence of HR-HPV was associated with development of more severe dysplasia (p=0.04, HGD OR 2.32 [95% CI 1.15-4.71]), 52.7% (68/129) of HR-HPV (-) encounters still returned with HGD. Among patients with any abnormal anal pap smear findings, HR-HPV detected HGD with 51.7% sensitivity, 62.5% specificity, 46.5% positive predictive value, 67.3% negative predictive value, and 58.3% accuracy.

Conclusion/Discussion: HR-HPV status should not be used as the sole factor to triage patients for HRA screening. Although patients with HR-HPV should undergo HRA, patients without HR-HPV still have significant risk for HGD. Additional studies are needed to better delineate the most suitable patients for HRA screening.