Anal cancer screening with high resolution anoscopy
Apostolos Stamatiadis and Ioannis Karaitianos
We studied the efficiency of direct high resolution anoscopy (HRA) as a screening tool for prevention of anal cancer in high risk individuals.
High resolution anoscopy was performed directly in high-risk individuals for development of anal cancer (anal warts, anal intercourse, high-grade cervical dysplasia, immunosuppression, HIV infection, history of anal cancer). There was no previous selection with anal cytology. HRA-guided biopsies were taken from lesions with colposcopic characteristics of HPV-induced high-grade anal intraepithelial neoplasia (HGAIN).
Between 2011-2015 431 individuals were examined with HRA. The biopsies showed high grade lesions in 63/431 patients (15%) There were 14/51 HIV-seropositive patients, 8/26 patients with high grade cervical lesions, 5/13 patients during anal cancer surveillance and 4/5 immunosuppressed patients. There was overlapping between above groups.
Direct-use of HRA-guided biopsy without previous anal cytology is a very effective screening tool for preclinical detection of high-grade HPV-induced anal dysplasias. The treatment of HGAIN lesions will prevent their transformation into invasive anal neoplasia.