We appreciate the comments from Dr. Wald concerning appropriate study design and labeling in the clinical and scientific literature and agree that careful characterization is paramount to investigators and readers alike.The statement, "all information and indicated biopsies were completed at the time of entry"1 refers to information and biopsies regarding anal evaluation only. Patients were screened for anal intraepithelial neo-plasia according to our protocol only after the diagnosis of genital intraepithelial neoplasia, not concurrently. Additional review by Dr. Thomas Riggs, Statistical Editor of Obstetrics & Gynecology, confirms there was a sequence to ascertainment.
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