Anal cancer prevention
Anal cancer can be prevented effectively with treatment of pre-malignant HGAIN lesions in the anus. In the early stages, HGAIN lesions cause no symptoms. They can be detected with simple anal cytology (Pap test) in high-risk individuals. Anal cytology smear is a simple procedure and is taken in the proctologist’s office. However, anal cytology has a small diagnostic value and direct high resolution anoscopy without any previous cytology has a much higher diagnostic yield. If anal cytology is positive, then high resolution anoscopy should follow for the localization of dysplasia and biopsy. The precancerous lesions (HGAIN) are localized with biopsy during HRA and treated easily with cauterization.
Prevention of anal cancer is easy, provided there is proper awareness and information by ] state authorities and medical providers. In Greece, prevention of anal cancer in gay men and HIV-positive is very limited because of faulty or even no awareness at all. In our clinic, examination for anal dysplasia and anal cancer prevention is available for more than four years.
Risk factors for acquiring HGAIN lesions and subsequent anal cancer are the following:
• 15 or more sexual partners
• Anal intercourse (examination every 2-3 years ) .
• Smoking
• Antecedent cervical dysplasia CIN3.
• Anal warts
• Kidney transplantation, immunosuppressive drugs , chronic steroid treatment.
• HIV Infection (annual examination is needed)
These groups should be checked regularly with anal cytology or HRA. Homosexual men should be checked regularly for HPV infection and dysplasias. Intra-anal warts are quite frequent in gay without any symptoms. Anal wart treatment is easy, and at the same time, high resolution anoscopy can look for any HGAIN dysplasia. If dysplasia is diagnosed, it is easily treated in our clinic. With regular follow-up as indicated, the probability of developing anal cancer is significantly reduced.
- PROCTOLOGY CLINIC- ATHENS GREECE