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Anal Squamous Intraepithelial Neoplasia

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Vulvar Disease

Abstract

Anal squamous intraepithelial lesions (ASILs) are part of the multicentric infection of the lower genital tract by the human papillomavirus (HPV). The rate of anal cancer during 2004–2008 in the United States among females was 1.8 per 100,000 and 1.2 per 100,000 among males.

Women with human immunodeficiency virus (HIV) infection have a higher risk compared to the general population. Early diagnosis may be prompted by a high index of suspicion, obtaining anal cytology, and performing high-resolution anoscopy (HRA) and a biopsy for those who have high risk factors. Treatments include application of trichloroacetic acid, imiquimod 5%, infrared coagulation, CO2 laser vaporization, and surgery. HPV vaccines have a high success rate in preventing ASIL caused by HPV.

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References

  1. Darragh TM, Colgan TJ, Cox JT, Heller DS, Henry MR, Luff RD, McCalmont T, Nayar R, Palefsky JM, Stoler MH, Wilkinson EJ, Zaino RJ, Wilbur DC, Members of LAST Project Work Groups. The Lower Anogenital Squamous Terminology Standardization Project for HPV-Associated Lesions: background and consensus recommendations from the College of American Pathologists and the American Society for Colposcopy and Cervical Pathology. J Low Genit Tract Dis. 2012;16(3):205–42.

    Article  Google Scholar 

  2. Scholefield JH, Harris D, Radcliffe A. Guidelines for management of anal intraepithelial neoplasia. Color Dis. 2011;13(Suppl 1):3–10.

    Article  Google Scholar 

  3. Palefsky J, Holly E. Molecular virology and epidemiology of human papillomavirus and cervical cancer. Cancer Epidemiol Biomark Prev. 1995;4:415–28.

    CAS  Google Scholar 

  4. Frisch M, Fenger C, van den Brule AJ, et al. Variants of squamous cell carcinoma of the anal canal and perianal skin and their relation to human papillomaviruses. Cancer Res. 1999;59:753–7.

    CAS  PubMed  Google Scholar 

  5. Daling JR, Madeleine MM, Johnson LG, et al. Human papillomavirus, smoking, and sexual practices in the etiology of anal cancer. Cancer. 2004;101:270–80.

    Article  Google Scholar 

  6. Varnai AD, Bollmann M. HPV in anal squamous cell carcinoma and anal intraepithelial neoplasia (AIN). Impact of HPV analysis of anal lesions on diagnosis and prognosis. Int J Color Dis. 2006;21:135–42.

    Article  CAS  Google Scholar 

  7. SEER Cancer Statistics Factsheets: Anal Cancer. http://seer.cancer.gov/statfacts/html/anus.html.

  8. Palefsky JM, Holly EA, Ralston ML, Da Costa M, Greenblatt RM. Prevalence and risk factors for anal human papillomavirus infection in human immunodeficiency virus (HIV)-positive and high-risk HIV-negative women. J Infect Dis. 2001;183(3):383–91.

    Article  CAS  Google Scholar 

  9. Moscicki AB, Hills NK, Shiboski S, Darragh TM, Jay N, Powell K, Hanson E, Miller SB, Farhat S, Palefsky J. Risk factors for abnormal anal cytology in young heterosexual women. Cancer Epidemiol Biomark Prev. 1999;8(2):173–8.

    CAS  Google Scholar 

  10. Palefsky JM, Rubin M. The epidemiology of anal human papillomavirus and related neoplasia. Obstet Gynecol Clin North Am. 2009;36:187–200.

    Article  Google Scholar 

  11. Palefsky JM, Holly EA, et al. Virologic, immunologic and clinical parameters in the incidence and progression of anal squamous intraepithelial lesions in HIV positive and HIV negative homosexual men. J Acquir Immune Defic Syndr Hum Retrovirol. 1998;17(4):314–9.

    Article  CAS  Google Scholar 

  12. Palefsky JM, Holly EA, Ralston ML, Arthur SP, Jay N, Berry JM, DaCosta MM, Botts R, Darragh TM. Anal squamous intraepithelial lesions in HIV-positive and HIV-negative homosexual and bisexual men: prevalence and risk factors. J Acquir Immune Defic Syndr Hum Retrovirol. 1998;17(4):320–6.

    Article  CAS  Google Scholar 

  13. Palefsky JM, Shiboski S, et al. Risk factors for anal human papillomavirus infection and anal cytologic abnormalities in HIV-positive and HIV-negative homosexual men. J Acquir Immune Defic Syndr. 1994;7:599.

    CAS  PubMed  Google Scholar 

  14. Welton ML, Sharkey FE, Kahlenberg MS. The etiology and epidemiology of anal cancer. Surg Oncol Clin N Am. 2004;13:263–75.

    Article  Google Scholar 

  15. Scholefield JH, Hickson WGE, Smith JHF, et al. Anal intraepithelial neoplasia: part of a multifocal disease process. Lancet. 1992;340:1271–3.

    Article  CAS  Google Scholar 

  16. Holly EA, Ralston ML, Darragh TM, et al. Prevalence and risk factors for anal squamous intraepithelial lesions in women. J Natl Cancer Inst. 2001;93:843–9.

    Article  CAS  Google Scholar 

  17. Moscicki AB, Hills NK, Shiboski S, Darragh TM, et al. Risk factors for abnormal anal cytology in young heterosexual women. Cancer Epidemiol Biomarkers Prev. 1999;8:173–8.

    CAS  PubMed  Google Scholar 

  18. Zbar AP, Fenger C, Efron J, et al. The pathology and molecular biology of anal intraepithelial neoplasia: comparisons with cervical and vulvar carcinoma. Int J Color Dis. 2002;17:203–15.

    Article  CAS  Google Scholar 

  19. Santoso JT, Long M, Crigger M, Wan JY, Haefner HK. Anal intraepithelial neoplasia in women with genital intraepithelial neoplasia. Obstet Gynecol. 2010;116(3):578–82.

    Article  Google Scholar 

  20. Tatti S, Suzuki V, Fleider L, Maldonado V, Caruso R, Tinnirello Mde L. Anal intraepithelial lesions in women with human papillomavirus-related disease. J Low Genit Tract Dis. 2012;16(4):454–9.

    Article  Google Scholar 

  21. Bean SM, Chhieng DC. Anal-rectal cytology: a review. Diagn Cytopathol. 2010;38(7):538–46.

    Article  Google Scholar 

  22. Abbasakoor F, Boulos PB. Anal intraepithelial neoplasia. Br J Surg. 2005;92(3):277–90.

    Article  CAS  Google Scholar 

  23. HIV Clinical Resource at http://www.hivguidelines.org/.

  24. Moscicki AB, Darragh TM, Berry-Lawhorn JM, et al. Screening for anal cancer in women. J Low Genit Tract Dis. 2015;19(3 Suppl 1):S27–42.

    PubMed  Google Scholar 

  25. Joura EA, Giuliano AR, et al. A 9-valent HPV vaccine against infection and intraepithelial neoplasia in women. N Engl J Med. 2015;372(8):711–23.

    Article  CAS  Google Scholar 

  26. Moreira ED Jr, Block SL, Ferris D, Giuliano AR, et al. Safety profile of the 9-valent HPV vaccine: a combined analysis of 7 phase III clinical trials. Pediatrics. 2016;138(2):e20154387.

    Article  Google Scholar 

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Tatti, S., Suzuki, V., Fleider, L. (2019). Anal Squamous Intraepithelial Neoplasia. In: Bornstein, J. (eds) Vulvar Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-61621-6_56

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  • DOI: https://doi.org/10.1007/978-3-319-61621-6_56

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-61620-9

  • Online ISBN: 978-3-319-61621-6

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