The Diagnostic and Therapeutic Challenge of Anal Intraepithelial Neoplasia
Purpose of Review
No single modality of care serves as the defined best practice for the treatment of anal intraepithelial neoplasia (AIN). This review aims to present the common treatment modalities germane to AIN while considering evolving evidence.
AIN affords an opportunity to evaluate and treat patients before the development of invasive diseases. Efforts to screen for AIN have yielded mixed results. The major available pharmacotheraputic and surgical options offer efficacious options to reduce the bioburden of disease but can be met with high levels of recurrent disease. None affords a predictably durable response in severe disease.
Vaccination as primary prevention will likely reduce the overall upward trend in AIN. Evidence suggests vaccination also affords improvement in recurrent disease. Early evidence reveals potential benefit in multimodal approaches to control AIN. Valuable data is anticipated from the phase III, randomized ANCHOR study evaluating the management of high-grade AIN in HIV +patients.
KeywordsAIN Anal intraepithelial neoplasia HPV Human papilloma virus
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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