AI Article Synopsis
- This study investigates the prevalence of intra-anal high-grade squamous intra-epithelial lesions (HSIL) in women with prior HPV-related vulvar or perianal diseases using high-resolution anoscopy (HRA).
- Between 2015 and 2018, 27 women were screened; results showed that while no anal cancer was detected, 22% had intra-anal HSIL and 44% were diagnosed with low-grade SIL.
- The findings suggest that screening for intra-anal lesions in these high-risk women could be important, and further research is needed to understand how treatment for HSIL might prevent anal cancer.
Article Abstract
Aim: Women with a history of human papillomavirus (HPV)-related cervical, vaginal or vulvar high-grade squamous intra-epithelial lesions (HSILs) or cancer are at increased risk of developing anal squamous intra-epithelial lesions (SILs) or a squamous cell carcinoma of the anus (SCCA). Screening for intra-anal SILs with high-resolution anoscopy (HRA) in high-risk populations is a subject of debate. In this study we aimed to answer the following question: what is the prevalence of intra-anal (H)SIL in women with HPV-related vulvar and/or perianal disease using HRA for screening?
Method: A retrospective study was performed to evaluate the prevalence of intra-anal (H)SIL in women with a history of vulvar and/or perianal HSIL or (superficially invasive) squamous cell carcinoma (SCC). This study was performed between 2015 and 2018 following implementation of a protocol for intra-anal screening using HRA.
Results: Twenty-seven patients, 10 with a history of (superficially invasive) SCC (four vulvar, five perianal, one multizonal) and 17 with HSIL as the worst diagnosis (two perianal, 15 multizonal) were screened for intra-anal lesions using HRA. No anal cancer was found at screening, 6 (22%) patients were diagnosed with intra-anal HSIL and 12 (44%) patients with intra-anal low-grade SIL.
Conclusions: We found a high prevalence of intra-anal HSIL in women previously diagnosed with vulvar and perianal HSIL. Given the clear link between HSIL and SCCA, screening for intra-anal lesions in women with HPV-related genital pathology seems warranted. Future studies should focus on the effect of HSIL treatment on the prevention of anal cancer.
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| http://dx.doi.org/10.1111/codi.15320 | DOI Listing |
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