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Prevalence of Abnormal Anal Cytology or HPV Testing in
Women with Abnormal Cervical Cytology or HPV Positive: A
Thai Hospital Experience
Supisara Mungkorntongsakul1
,Nanthanut Mungkornthongsakul2, Pimkul Luamprapat1, Kittipong Panpanawan2
,
Komsun Suwannarurk3, Awassada Punyashthisa3*
1 Department of Obstetrics and Gynecology, Faculty of Medicine, Siriraj Mahidol University
2 Faculty of Medicine, Thammasat University
3 Gynecologic Oncology Unit Department of Obstetrics & Gynecology Faculty of Medicine, Thammasat
University
*Corresponding Author E-mail: awassada.pu@gmail.com
Background: Abstract
Anal cancer incidence is increasing among women, with over 9,700 new cases in the U.S. in
2023 and 355 in Thailand in 2020. Most are diagnosed at late stages, while early detection
enables effective treatment. Although routine screening is not recommended for the general
population, women with cervical HPV may benefit from targeted surveillance, as over 90%
of anal cancers are linked to high-risk HPV types, particularly 16 and 18. This study aimed
to evaluate the prevalence of abnormal anal cytology and anal HPV infection in women
with abnormal cervical cytology or positive cervical HPV testing and to estimate anal
intraepithelial neoplasia (AIN) using anal cytology, HPV mRNA, and DNA testing.
Methods: From December 2023 to December 2024, 96 women aged ≥25 years referred for colposcopy
due to abnormal cervical findings were enrolled. Anal samples were tested for cytology,
HPV DNA, and HPV mRNA.
Results: Conclusions: Seventeen of the 96 participants (17.7%) had abnormal anal results. Among 82 women
with abnormal cervical cytology (≥ ASCUS), 15 (18.3%) also had abnormal anal cytology,
but this was not statistically significant (P = 1.0). However, cervical HPV 16/18 positivity
was significantly associated with abnormal anal cytology (OR = 4.513, P = 0.01), with 61.9%
of HPV 16/18-positive women showing abnormal results. No significant associations were
found with age, education, income, number of sexual partners, HPV vaccination, STD
history, or oral sex practices.
Cervical HPV 16/18 positivity is significantly associated with abnormal anal cytology.
These findings support targeted anal cancer screening in high-risk women to enable early
detection and improve clinical outcomes.
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