Is there a role for the thinprep imaging system in reporting anal cytology?

Jennifer Margaret Roberts*, Fengyi Jin, Deborah Ekman, Marjorie Kay Adams, Ross Lindsay McDonald, Julia Kathleen Thurloe, Adele Richards, Isobel Mary Poynten, Carmella Law, Christopher Kincaid Fairley, Richard John Hillman, Sepehr N. Tabrizi, Alyssa Marie Cornall, David James Templeton, Suzanne Marie Garland, Andrew Edwin Grulich, Annabelle Farnsworth

*Corresponding author for this work

Research output: Contribution to journalArticle


Background The ThinPrep Imaging System (TIS) is an accurate time-saving method of reading cervical ThinPrep slides in screening programs. As anal and cervical cytology are morphologically similar, TIS can potentially be used for anal cytology. We assessed the performance of TIS on anal ThinPrep slides from homosexual men in a natural history study of human papillomavirus-related anal abnormalities. Methods Four hundred nineteen anal cytology slides were processed by TIS and classified by a cytologist as either No further review (slide archived) or Manual review (slide requiring full manual screen). The results were compared with the original manual screening report for all slides and specifically for those screening episodes accompanied by a high-grade squamous intraepithelial lesion (HSIL) on concurrent biopsy. Results One hundred seventy six of 419 (42.0%) slides were classified as No further review, with a trend of decreasing proportions as the degree of severity of the cytological abnormality increased. Thirteen (27.7%) slides with an original unsatisfactory report were classified as No further review. Eighty two (92.1%) of those with biopsy HSIL and cytological abnormality were classified for Manual review, including all 45 (100%) with cytological HSIL. Conclusion The cervical algorithm of TIS performed best on anal samples when HSIL was present both cytologically and histologically. The 27.7% unsatisfactory slides classified as No further review may indicate need for use of different criteria from cervical cytology. Because of the high prevalence of abnormalities, and hence the large proportion of slides needing manual review, the cytologist time-saving would compare unfavorably with use of TIS in cervical screening.

Original languageEnglish
Pages (from-to)384-388
Number of pages5
JournalDiagnostic Cytopathology
Issue number5
Publication statusPublished - 1 May 2016
Externally publishedYes


  • anal cytology
  • ThinPrep imaging
  • high-grade squamous intraepithelial lesion

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    Margaret Roberts, J., Jin, F., Ekman, D., Kay Adams, M., Lindsay McDonald, R., Kathleen Thurloe, J., ... Farnsworth, A. (2016). Is there a role for the thinprep imaging system in reporting anal cytology? Diagnostic Cytopathology, 44(5), 384-388.