High prevalence of anal squamous intraepithelial lesions and squamous-cell carcinoma in men who have sex with men as seen in a surgical practice

Abstract

Men who have sex with men referred for treatment of either condyloma or noncondylomatous benign anorectal disease had a high prevalence of anal high-grade squamous intraepithelial lesions and anal squamous-cell cancer. All men who have sex with men referred for treatment of benign anorectal disease should have high-resolution anoscopy and aggressive biopsy of all abnormal areas. Treatment of external lesions alone could miss high-grade squamous intraepithelial lesions or anal squamous-cell cancer.

Anorectal cytology as a screening tool for anal squamous lesions

“…Many published studies advocate the use of cytology in the diagnosis of anal lesions because of similarities to cervical disease and its cost-effectiveness. 9,10 Fewer studies, however, have described the cytomorphologic features and diagnostic limitations associated with this new specimen type. [13][14][15] The current study evaluated the use of anorectal cytology in a high-risk population and the cytomorphologic features associated with a variety of anorectal lesions.…”

“…Other published studies confirmed the diagnostic difficulties associated with accurately grading anorectal neoplasia. 10,11 Palefsky et al 11 showed that the grade of disease on anal cytology did not always correspond to the histologic grade. However, Goldstone et al 10 reported that the diagnosis of HSIL in cytology specimens corresponded to a high probability that HSIL would be found at anoscopy.…”

“…10,11 Palefsky et al 11 showed that the grade of disease on anal cytology did not always correspond to the histologic grade. However, Goldstone et al 10 reported that the diagnosis of HSIL in cytology specimens corresponded to a high probability that HSIL would be found at anoscopy. The cytologic diagnosis of LSIL or HSIL with a negative biopsy should not dismiss the absence of severe AIN disease.…”

“…9 Moreover, both lesions arise frequently in the squamocolumnar epithelium junction. 10 Cytology has been proposed as a potential screening tool in the evaluation of anorectal specimens for anorectal disease because of the morphologic similarities of anal and cervical SQC and intraepithelial neoplasias. 10,11 In addition, cytologic screening is recognized as a cost-effective and simple method.…”

“…10 Cytology has been proposed as a potential screening tool in the evaluation of anorectal specimens for anorectal disease because of the morphologic similarities of anal and cervical SQC and intraepithelial neoplasias. 10,11 In addition, cytologic screening is recognized as a cost-effective and simple method. Recently, the 2001 Bethesda guidelines for cervical cytology included an appendix for anal cytology.…”