Anal intraepithelial neoplasia

Diagnosis, screening, and treatment

Ragavan V. Siddharthana, Christian Lanciault, Vassiliki Tsikitis

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Anal intraepithelial neoplasia (AIN) is a premalignant lesion for anal cancer. It is more commonly found in high-risk patients (e.g., human papilloma virus (HPV)/human immunodeficiency virus infections, post-organ transplantation patients, and men who have sex with men) and development is driven by HPV infection. The incidence of AIN is difficult to estimate, but is heavily skewed by preexisting conditions, particularly in high-risk populations. The diagnosis is made from cytology or biopsy during routine examinations, and can be performed at a primary care provider’s office. A pathologist can then review and classify cells, based on nucleus-to-cytoplasm ratios. The classification of low or high grade can better predict progression from AIN to anal cancer. There is little debate that AIN can develop into anal cancer, and the main rationale for treatment is to delay the progression. Significant controversy remains regarding screening, surveillance, and treatment for AIN. Management options are separated into surveillance (watchful waiting) and interventional strategies. Emerging data suggest that close patient follow up with a combination of ablative and topical treatments may offer the greatest benefit. HPV vaccination offers a unique treatment prior to HPV infection and the subsequent development of AIN, but its use after the development of AIN is limited. Ablative treatment includes excision, fulguration, and laser therapy.

Original languageEnglish (US)
Pages (from-to)257-263
Number of pages7
JournalAnnals of Gastroenterology
Volume32
Issue number3
DOIs
StatePublished - May 3 2019

Fingerprint

Papillomaviridae
Anus Neoplasms
Virus Diseases
Neoplasms
Therapeutics
Watchful Waiting
Preexisting Condition Coverage
Laser Therapy
Organ Transplantation
Cell Biology
Primary Health Care
Cytoplasm
Vaccination
HIV
Biopsy
Incidence
Population

Keywords

  • Anal intraepithelial neoplasia
  • Hpv-related squamous epithelial dysplasia
  • Human papilloma virus (HPV)

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Anal intraepithelial neoplasia : Diagnosis, screening, and treatment. / Siddharthana, Ragavan V.; Lanciault, Christian; Tsikitis, Vassiliki.

In: Annals of Gastroenterology, Vol. 32, No. 3, 03.05.2019, p. 257-263.

Research output: Contribution to journalArticle

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