Understanding HPV
HPV is one of the most common sexually transmitted infections globally, with over 150 types—about 40 affecting the genital and anal areas. Some types cause benign warts; others are linked to cancers of the cervix, anus, throat, and pharynx.
Transmission & Risk
HPV is transmitted via sexual contact, regardless of gender or orientation. Most infections are asymptomatic and resolve within two years. However, high-risk types (like 16 and 18) may cause precancerous lesions and cancer.
Anal HPV infection is common in high-risk groups: 60% in MSM vs. 15% in heterosexual men. Transmission can occur via skin contact, fingers, objects, or indirect exposure. Condoms reduce but don’t eliminate risk. HIV-positive individuals are especially vulnerable due to reduced immunity.
Clinical Effects of HPV
- Benign lesions: Types 6 and 11 cause warts—harmless but bothersome growths.
- Oncogenic lesions: Types 16 and 18 can cause HSIL, a precursor to cancer.
- Cancer risk: HSIL has a 10–15% risk of progressing to cancer within 3–5 years, especially in immunocompromised patients.
Anal Cancer Risk Factors
- HIV infection and low CD4 counts
- Immunosuppressive therapy
- Smoking
- Multiple sexual partners
- History of HPV-related dysplasia
HPV and Anal Cancer
Anal cancer is rare in the general population but more common in MSM and HIV+ individuals. MSM are 20 times more likely to develop anal cancer. Half of HIV+ gay men develop HSIL, and 10% may progress to cancer.
Diagnosis and Monitoring
- Pap test: Screens for precancerous anal changes.
- High-Resolution Anoscopy (HRA): Detailed visualization and biopsy for confirmation.
- Regular check-ups: every 3 years for MSM, annually for HIV+ patients.
Prevention and Treatment
- Pap test and HRA screening
- HPV vaccination
- Treatment of precancerous lesions: cauterization, cryotherapy, topical treatments
ANCHOR Study Insights
The ANCHOR study confirmed that treating HSIL significantly reduces anal cancer risk, especially in HIV+ individuals. It showed that:
- Ongoing monitoring is crucial
- Early intervention prevents cancer
- Safe treatment options exist (laser, cryo, topical)
High-Resolution Anoscopy (HRA)
HRA is a detailed diagnostic procedure using a high-definition microscope and acetic acid/Lugol’s iodine to detect HSIL.
- Detects changes not visible to the naked eye
- Allows for immediate biopsy
- Outpatient, painless, safe
- Enables treatment and follow-up
Why Choose Our Clinic?
Our proctology clinic performs HRA using the latest equipment, following international guidelines. We offer:
- Accurate diagnosis and personalized care
- Advanced HPV and HSIL management
- Experience in high-risk patient care (MSM, HIV+, HPV history)
Conclusion
We apply the ANCHOR study’s protocols to provide early diagnosis, individualized treatment, and continuous monitoring for patients at risk. For more information or to book an HRA appointment, contact us today.
