Anal Intraepitheial Neoplasia

  • Amy L. Lightner
  • Cindy J. Kin
  • Mark L. WeltonEmail author


The ultimate goals of treating patients with high-grade squamous intraepithelial lesion (HSIL) are preventing morbidity associated with the treatment of anal cancer and mortality from anal cancer itself without causing disturbances of anal function, i.e., continence of stools and flatus. Fortunately, there are low cost, outpatient tools to treat HSIL, and evidence to support their effectiveness in preventing Anal squamous cell carcinoma (ASCC). Although there is an ongoing trial looking at surveillance rather than treatment for HSIL, at this time, treatment should be endorsed especially given its ease to perform. Ultimately, prevention, screening, and treatment of anal HSIL should be as widespread as that for cervical dysplasia. But to achieve this goal, clinicians need to be educated and dedicated to the eradication of this disease; that includes learning high resolution anoscopy (HRA) and willingness to follow patients longitudinally. Hopefully, in the future, rates of ASCC will be minimized with the use of Human papilloma virus (HPV) vaccine and screening for HSIL.


High-grade squamous intraepithelial lesion High resolution anoscopy Anal intraepitheial neoplasia Human papilloma virus Anal squamous cell carcinoma Anal cancer 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Amy L. Lightner
    • 1
  • Cindy J. Kin
    • 2
  • Mark L. Welton
    • 3
    Email author
  1. 1.Department of Colon and Rectal SurgeryCleveland ClinicClevelandUSA
  2. 2.Department of SurgeryStanford University School of MedicineStanfordUSA
  3. 3.Fairview Health Services, Corporate Department and Department of SurgeryUniversity of MinnesotaMinneapolisUSA

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