Anal cancer and intraepithelial neoplasia screening: A review

Table 1 Summary characteristics of anal cancer screening modalities

	DARE	Anal Pap test	HPV testing	High resolution anoscopy
Sensitivity[56,57,61,62,101]	Not studied	69%-93%	Alone: 100%	Current diagnostic standard
			Co-testing with Pap[49]: 72%-96%
Specificity[56,57,61,62,101]	Not studied	32%-59%	Alone: 16%	Current diagnostic standard
Resource availability	N/A	Ubiquitous	Ubiquitous	Highly selective centers
Provider availability	Universal	Specialty clinics	Specialty clinics	Highly selective centers
Learning curve	Part of usual clinical training	Part of usual clinical training	Part of usual clinical training	> 200 cases
Current consensus[52]	Annually, all HIV-positive patients	Annually in highest-risk groups	Alone: No recommendation	Second-line screen following positive Pap test
			Co-testing: No recommendation

DARE: Digital anorectal exam; HPV: Human papilloma virus; N/A: Not applicable; HIV: Human immunodeficiency virus; Pap: Papanicolaou.