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Screening, Surveillance, and Treatment of Anal Intraepithelial Neoplasia.
Clin Colon Rectal Surg
March 2016
Swedish Colon and Rectal Clinic, Swedish Medical Center Department of Surgery, Seattle, Washington.
Article Synopsis
- The incidence of anal intraepithelial neoplasia is rising, particularly among high-risk groups like MSM (men who have sex with men), HIV-positive individuals, and the immunosuppressed.
- The progression to invasive anal cancer from high-grade lesions is about 5%, but higher for high-risk patients, and while anal cytology is used for screening, it doesn’t reliably connect to actual disease presence.
- Treatment options range from nonoperative methods like topical medications to surgical procedures, but there are still high recurrence rates, emphasizing the need for vigilant surveillance, with no established optimal follow-up guidelines.