Thus, we sought to establish a strong multidisciplinary group for anal cancer prevention and management of anal dysplasia in the Chicago metro area by reviewing results of anal cytology, anoscopy
, anal biopsy, and early results of HR-HPV reflex testing for atypical squamous cells of undetermined significance (ASCUS).
Referral to gastroenterology for anoscopy
, sigmoidoscopy, or colonoscopy is recommended.
Proper et al., "High resolution anoscopy
findings for men who have sex with men: inaccuracy of anal cytology as a predictor of histologic high-grade anal intraepithelial neoplasia and the impact of HIV serostatus," Clinical Infectious Diseases, vol.
Colposcopy has a mean 90% specificity for diagnosis of HPV-related high-grade squamous intraepithelial lesions (HSIL) or cervical cancer, while high-resolution anoscopy
as a diagnostic test has a specificity as low as 37% in HIV-positive persons.
Among 1392 study participants who did not have HSIL confirmed by biopsy before the study, 220 (16%) had high-resolution anoscopy
and biopsy during the study.
The clinical details were noted, which included inspection of perianal region, digital rectal examination and anoscopy
Non-controlled studies have shown variable results with trichloroacetic acid (Singh, Kuohung, & Palefsky, 2009) and high-resolution anoscopy
(HRA) targeted ablation (Cranston, Hirschowitz, Cortina, and Moe, 2008; Goldstone, Hundert, & Huyett, 2007; Nathan, Hickey, Mayuranathan, Vowler, & Singh, 2008; Pineda et al., 2008).
Investigators followed these subjects every 6 months for 36 months with polymerase chain reaction testing for HPV DNA, high-resolution anoscopy
with anal cytology, and anal biopsy and histology if there were atypia.
* 46601, Anoscopy
; diagnostic, with high-resolution magnification (HRA) (eg colposcope, operating microscope) and chemical agent enhancement, including collection of specimen(s) by brushing or washing when performed
and flexible proctoscopy revealed no disruption of the mucosa or other abnormalities anywhere.
If cytology indicates anal cell abnormalities, then we refer them for high-resolution anoscopy
and biopsy of suspicious lesions.