Progression From Perianal High-Grade Anal Intraepithelial Neoplasia to Anal Cancer in HIV-Positive Men Who Have Sex With Men

Tinmouth, Jill; Peeva, Valentina; Amare, Henok; Blitz, Sandra; Raboud, Janet; Sano, M.; Steele, Leah S.; Salit, Irving E.

doi:10.1097/dcr.0000000000000644

Cited by 27 publications

(30 citation statements)

References 30 publications

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“…For HRA to be successful as a cancer prevention strategy, it needs to be both effective and tolerable to the target patient population. While previous studies have examined the clinical utility and performance of HRA [11,[14][15][16][17][18][19][20][21], few have documented patient experience with HRA, including the tolerability of discomfort during the procedure and postprocedure pain, as well as patient willingness to undergo routine or follow-up HRA [14,22,23].…”

Section: Introductionmentioning

confidence: 99%

Acceptability of high‐resolution anoscopy for anal cancer screening in HIV‐infected patients

et al. 2018

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Section: Introductionmentioning

confidence: 99%

Acceptability of high‐resolution anoscopy for anal cancer screening in HIV‐infected patients

et al. 2018

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“…Progression from anal HSIL to cancer was also reported to be high in another study. 7of 38 patients (18%) followed in Toronto Canada with perianal HSIL developed anal cancer, with a progression rate of 6.9 cases of anal cancer per 100 person-years of follow-up (7). …”

Section: Introductionmentioning

confidence: 99%

Human papillomavirus-associated anal and cervical cancers in HIV-infected individuals

Palefsky

2017

Current Opinion in HIV and AIDS

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Purpose of review The incidence of human papillomavirus (HPV)-related cancers has increased (anal cancer) or not declined (cervical cancer) since the introduction of antiretroviral therapy (ART). This article reviews recent data on incidence and prevention efforts for HPV-related cancers in the ART era. Recent findings ART may confer some benefit with respect to reducing the risk of anal HSIL and cancer, but the degree of that benefit appears to be limited. The prevalence of anal HPV infection, anal HSIL and anal cancer remain high among individuals on effective ART. The incidence of cervical cancer is high among HIV-infected women, particularly in countries where there are no organized cervical cancer prevention programs. Efforts are in progress to define optimal screen-and-treat cervical cancer prevention programs in different clinical settings and to define the efficacy of secondary prevention programs for prevention of anal cancer. Summary HPV-related cancers are likely to remain an important problem in HIV-infected men and women for the foreseeable future, even among those on effective ART.

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“…Anal intraepithelial neoplasia (AIN) is dysplasia in the epithelium of the anus and is a pre‐malignant condition associated with a low rate of progression to invasive squamous cell carcinoma (SCC) . The Bethesda system (2001) defines AIN I as low grade dysplasia with nuclear abnormalities confined to the lower third of the mucosa, also known as low grade squamous intraepithelial lesion.…”

Section: Introductionmentioning

confidence: 99%

“…The overall incidence of anal SCC is rare (0.9/100 000) but studies have demonstrated an increasing incidence in recent decades. There is a noticeable increase of AIN and SCC in the human immunodeficiency virus (HIV) population and men who have sex with men (MSM) . It is reported that in MSM, the incidence is 35/100 000 and if they are HIV positive with MSM the rate is significantly higher at 144/100 000, while the prevalence of AIN in HIV positive MSM is 29.1% and HIV negative MSM is 21.5% .…”

Section: Introductionmentioning

confidence: 99%

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Clinical evaluation of anal intraepithelial neoplasia: are we missing the boat?

Yeoh

Bell

Farmer

et al. 2018

ANZ Journal of Surgery

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Background: Anal intraepithelial neoplasia (AIN) is dysplasia in the epithelium of the anus and is a pre-malignant condition associated with a low rate of progression to invasive squamous cell carcinoma (SCC). The natural history of progression for AIN to anal SCC is poorly defined. This study aims to review our experience with AIN and investigate the natural history of progression. Methods: Data on all patients with AIN from January 2005 to December 2015 were retrospectively reviewed. Three separate databases were searched -Colorectal, Radiation Oncology and Infectious Diseases. All databases were cross-referred to obtain a complete but non-duplicated data set. Electronic charts were reviewed to obtain clinical information. Results: Twenty-eight patients were identified with AIN of various grades. There were 25 males, three females. Twenty of the male patients were human immunodeficiency virus (HIV) positive. Mean length of follow up was 56 months. Complete regression of AIN to normal was noted in 13 patients (46%). Four patients had persisting AIN III with no evidence of regression or malignant transformation. Nine patients with pre-existing AIN developed SCC (32%). Seven were positive for HIV infection (all males). Median time to progression was 36 months. None of the patients demonstrated clear linear pattern of progression of AIN to SCC. Conclusion: High grade AIN may progress to anal SCC and surveillance is indicated. The exact natural history of progression for AIN is difficult to predict. There is no linear progression over time evident. HIV patients with AIN are at higher risk of developing SCC. © 2018 Royal Australasian College of Surgeons ANZ J Surg 89 (2019) E1-E4ANZJSurg.com 15 (13%) 26 (23%) 3 (2.6%) 113

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Progression From Perianal High-Grade Anal Intraepithelial Neoplasia to Anal Cancer in HIV-Positive Men Who Have Sex With Men

Abstract: HIV-positive men who have sex with men should be monitored for perianal high-grade intraepithelial neoplasia. Those with high-risk features for the development of anal cancer may need more aggressive therapy.

Cited by 27 publications

References 30 publications

Acceptability of high‐resolution anoscopy for anal cancer screening in HIV‐infected patients

Acceptability of high‐resolution anoscopy for anal cancer screening in HIV‐infected patients

Human papillomavirus-associated anal and cervical cancers in HIV-infected individuals

Clinical evaluation of anal intraepithelial neoplasia: are we missing the boat?

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