Diagnosis and Treatment of Anal Squamous Cell Carcinoma
Case Summary:
A 61-year-old woman with ongoing tobacco use was referred to a colorectal surgery clinic after a screening colonoscopy found irregular lesions at the dentate line with biopsies revealing a high-grade squamous intraepithelial lesion. She reported scant bleeding and irregular bowel function, but no incontinence. She has a history of abnormal Papanicolaou tests, but has since undergone a hysterectomy and has no history of immunosuppressive treatment or HIV. She was taken for an examination under anesthesia that revealing a 2.5-cm mass in the anal canal and was biopsied. Pathological examination confirmed anal ...
Source: Diseases of the Colon and Rectum - September 18, 2020 Category: Gastroenterology Tags: Resident’s Corner Source Type: research
The importance of anal cancer screening and high-resolution anoscopy to gastroenterology practice
Purpose of review
Although human papillomavirus (HPV)-related anal squamous cell cancer (ASCC) is rare, its incidence has been rising and in high-risk populations exceeds the incidence of cancers for which screening programs are implemented. Therefore, targeted screening techniques are being evaluated with high-resolution anoscopy (HRA) as the current gold standard because of its ability to detect anal intraepithelial dysplasia (AIN) and premalignant high-grade squamous intraepithelial lesions (HSILs). However, a scarcity of trained providers presents a barrier to screening.
Recent findings
ASCC incidence is rising es...
Source: Current Opinion in Gastroenterology - August 4, 2020 Category: Gastroenterology Tags: ENDOSCOPY: Edited by Anthony N. Kalloo Source Type: research
Racial Disparities in Anal Cancer Screening Among Men Living With HIV: Findings From a Clinical Cohort Study
Conclusion:
Our findings highlight the potential for disparities in anal cancer screening that need to be considered when developing guidelines and screening programs to reduce the burden of anal cancer among men living with HIV and ensure health equity. (Source: JAIDS Journal of Acquired Immune Deficiency Syndromes)
Source: JAIDS Journal of Acquired Immune Deficiency Syndromes - June 16, 2020 Category: Infectious Diseases Tags: Clinical Science Source Type: research
Negative Predictive Value of Human Papillomavirus Testing: Implications for Anal Cancer Screening in People Living with HIV/AIDS.
Conclusions: In this series, anal hrHPV DNA testing offered 92% NPV for PLWHA; in other words, a 8% risk of occult precancer remains for those who test hrHPV negative on anal swab samples.
PMID: 32411239 [PubMed] (Source: Journal of Oncology)
Source: Journal of Oncology - May 17, 2020 Category: Cancer & Oncology Tags: J Oncol Source Type: research
Mucopexy-Recto Anal Lifting (MuRAL) in managing obstructed defecation syndrome associated with prolapsed hemorrhoids and rectocele: preliminary results.
Conclusion: MuRAL associated with modified Block technique gave no severe complications and resulted in a safe and effective approach to symptomatic rectocele associated with muco-rectal prolapse. Further randomized studies, larger series, and longer follow-up are needed.
PMID: 32411633 [PubMed] (Source: Annals of Surgical Treatment and Research)
Source: Annals of Surgical Treatment and Research - May 16, 2020 Category: Surgery Tags: Ann Surg Treat Res Source Type: research
Fundamentals of Anorectal Technical Skills: A Concise Surgical Skills Course.
CONCLUSION: This course provides a cost-effective training that significantly boosts learners' confidence in diagnosis of common anorectal procedures and confidence in performance of common anorectal procedures, in addition to improving objectively measured anorectal clinical knowledge.
PMID: 32313930 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - April 22, 2020 Category: International Medicine & Public Health Tags: Mil Med Source Type: research
Brief Report: Recurrence of Anal High-Grade Squamous Intraepithelial Lesions Among Women Living With HIV
Conclusion:
Most WLHIV treated for anal HSIL recurred within 3 years, suggesting need for continued surveillance after treatment. Our data contribute to the information needed to develop effective anal cancer prevention guidelines in WLHIV. (Source: JAIDS Journal of Acquired Immune Deficiency Syndromes)
Source: JAIDS Journal of Acquired Immune Deficiency Syndromes - April 9, 2020 Category: Infectious Diseases Tags: Clinical Science Source Type: research
Acceptability of anal cancer screening tests for women living with HIV in the EVVA study.
Conclusions: Most participating women considered anal cancer screening necessary and very acceptable. Longer screening intervals and adequate pain management could further increase the acceptability of repeated screening.
PMID: 32218656 [PubMed - as supplied by publisher] (Source: Current Oncology)
Source: Current Oncology - March 29, 2020 Category: Cancer & Oncology Tags: Curr Oncol Source Type: research
Satisfaction with high-resolution anoscopy for anal cancer screening among men who have sex with men: a cross-sectional survey in Abuja, Nigeria
Men who have sex with men (MSM) living with HIV are at increased risk for anal cancer. We evaluated satisfaction with first-time anal cancer screening using high resolution anoscopy (HRA) as a cross sectional ... (Source: BMC Cancer)
Source: BMC Cancer - February 5, 2020 Category: Cancer & Oncology Authors: Rebecca G. Nowak, Chinedu H. Nnaji, Wuese Dauda, Andrew Mitchell, Oluwole Olaomi, Paul Jibrin, Trevor A. Crowell, Stefan D. Baral, Nicaise Ndembi, Manhattan E. Charurat, Joel M. Palefsky, S øren M. Bentzen and Kevin J. Cullen Tags: Research article Source Type: research
Selective intra-arterial embolization to treat hemorrhoids.
CONCLUSIONS: Our initial results suggest that selective intra-arterial embolization is a safe and painless procedure that is well tolerated because it avoids rectal trauma and patients recover immediately.
PMID: 32029240 [PubMed - as supplied by publisher] (Source: Radiologia)
Source: Radiologia - February 2, 2020 Category: Radiology Authors: Ferrer Puchol MD, Esteban Hernández E, Blanco González FJ, Ramiro Gandia R, Solaz Solaz J, Pacheco Usmayo A Tags: Radiologia Source Type: research
Anal cancer screening in a high-risk behavior group: A local picture
ConclusionsThrough the study it was possible to construct a flow of referrals from the SAE to the UFSJ Coloproctology outpatient clinic. Moreover, the existence of internal stigmas on the part of the participants regarding the proctological examination and the lack of information about anal cancer screening are challenges to be overcome.ResumoObjetivos do estudoRealizar o rastreamento de lesões anais e câncer anal em homens vivendo com HIV/AIDS.MétodosTrata-se de estudo descritivo observacional transversal, cujos dados foram obtidos no Serviço de Assistência Especializada (SAE) em Divinópolis, Minas Gerais. Foi aplic...
Source: Journal of Coloproctology - January 28, 2020 Category: Gastroenterology Source Type: research
Prevalence and associations of larger burden of intra-anal high-grade squamous intraepithelial lesions at baseline in an Australian cohort of gay and bisexual men: The Study of the Prevention of Anal Cancer
ConclusionThe observation that men with a larger burden of HSIL also had more risk factors for anal cancer suggests this group may warrant closer observation to ensure earlier detection, and thus improved prognosis, of individuals whose HSIL may progress to anal cancer. (Source: Cancer Epidemiology)
Source: Cancer Epidemiology - January 7, 2020 Category: Cancer & Oncology Source Type: research
Benign Anorectal Conditions: Evaluation and Management.
Abstract
Common anorectal conditions include hemorrhoids, perianal pruritus, anal fissures, functional rectal pain, perianal abscess, condyloma, rectal prolapse, and fecal incontinence. Although these are benign conditions, symptoms can be similar to those of cancer, so malignancy should be considered in the differential diagnosis. History and examination, including anoscopy, are usually sufficient for diagnosing these conditions, although additional testing is needed in some situations. The primary treatment for hemorrhoids is fiber supplementation. Patients who do not improve and those with large high-gr...
Source: American Family Physician - December 31, 2019 Category: Primary Care Authors: Cohee MW, Hurff A, Gazewood JD Tags: Am Fam Physician Source Type: research
Early Detection of Anal High-Grade Squamous Intraepithelial Lesion: Do We Have an Impact on Progression to Invasive Anal Carcinoma?
Conclusions
Patients with macroscopic histologically proven HSIL at first diagnosis of anal intraepithelial lesion have a significantly higher risk of anal cancer compared with patients with microscopic lesions diagnosed during HRA, but the duration between the first diagnosis of HSIL and cancer does not differ between the 2 groups. (Source: Journal of Lower Genital Tract Disease)
Source: Journal of Lower Genital Tract Disease - December 21, 2019 Category: OBGYN Tags: Anal Disease Source Type: research
Assessment of Anal Cancer Screening Tools in Detecting High-Grade Anal Squamous Intraepithelial Lesions in Women
Objective
The aim of the study was to evaluate the validity of anal cytology against high-resolution anoscopy in the detection of anal high-grade squamous intraepithelial lesions (HSILs) among women in a clinical setting in Puerto Rico, alone and in combination with high-risk human papillomavirus (HR-HPV) typing.
Materials and Methods
A cross-sectional study was done among 128 eligible women who attended the Anal Neoplasia Clinic of the University of Puerto Rico Comprehensive Center between 2014 and 2019. Kappa (κ) coefficient, sensitivity, specificity, positive predictive value, and negative predictive value were ca...
Source: Journal of Lower Genital Tract Disease - December 21, 2019 Category: OBGYN Tags: Anal Disease Source Type: research
