ANAL PAP AS SECONDARY PREVENTION:
An exercise in evidence based medicine
(MAXIMIZE PAGE FOR OPTIMUM VIEWING)
The anal pap is a procedure that is being used by many health care providers as a screening tool for high-grade anal dysplasia, a lesion thought to be a precursor to anal cancer. The incidence of this tumor appears to be higher in men who have sex with men (MSMs) and HIV+ patients when compared to the rest of the general population. The goal of the following document is to test the hypothesis that the anal pap should be implemented as a secondary preventative strategy.
There is no clear test with a binary result of yes or no to help clinicians discern whether an intervention should be implemented as a screening test or not. Approaching the anal pap in an evidence-based approach, however, may help clinicians make a decision about inclusion or exclusion of this intervention in their daily practice.
What then makes a good screening test? Several elements come together to help clinicians decide which interventions merit inclusion into their battery of screening interventions. Let's apply these to the anal pap as a means of evaluating this test for inclusion in the practice’s screening guidelines.
Hypothesis: The anal pap is an appropriate screening tool for HSIL as a precursor to anal cancer in at risk groups.
Test: Does the anal pap meet criteria for inclusion in routine screening? |
