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.

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.
JZ

Joy Zhang, MD

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

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.
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 of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.
SB

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

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

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.
Nikita Wadhwani, MD (she/her/hers)

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

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This individual has no financial relationships with ineligible companies.
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

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This individual has no financial relationships with ineligible companies.
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

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Amber L. Traugott, MD (she/her/hers)

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

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Lisa A. Cunningham, MD

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

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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 of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

All of the relevant financial relationships listed below have been mitigated.

Joy Zhang, MD: This individual has no financial relationships with ineligible companies.

Melik Kagan Aktas, MD: This individual has no financial relationships with ineligible companies.

Sydney C. Beache, MD, MPHS: This individual has no financial relationships with ineligible companies.

Nikita Wadhwani, MD: This individual has no financial relationships with ineligible companies.

Emily Huang, MD, MEd: This individual has no financial relationships with ineligible companies.

Matthew F. Kalady, MD: This individual has no relevant relationships with ineligible companies.

Lisa A. Cunningham, MD: This individual has no financial relationships with ineligible companies.

Syed Husain, MB.,BS.: This individual has no financial relationships with ineligible companies.

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.