Anal squamous carcinoma is potentially a preventable disease. In the absence of primary prevention through HPV vaccination, prevention of HPV-related cancers, such as cervical cancer, are reliant upon the detection of precancer stage through screening and subsequent treatment of the precancer. High resolution anoscopy (HRA) enables the detection and management of anal high-grade squamous intraepithelial lesions (HSIL) in the field of anal cancer.
Newly published data relating to anal neoplasia field was searched and analysed.
There is now international consensus in defining the standards for practice of HRA. Some recent data suggest that a proportion of untreated anal HSIL may spontaneously regress while other data suggest anal HSIL can lead to invasive anal carcinoma. A number of topical and ablative modes of treatment of anal HSIL are available. We will discuss aspects of persistence / progression vs regression in this presentation. A number of factors that may impact on progression will also be discussed. Management of multizonal anogenital neoplasia in women will additionally be presented.
A number of new developments have taken place in the field of anal neoplasia resulting in better understanding of the disease and its management.