Evaluation of High Resolution Endoscopy Compared to the High Resolution Anoscopy for Detection of Early Dysplastic or Neoplastic Lesions of the Anal Canal in High−Risk Patients
There is a strong correlation between HPV infection and anal squamous cell cancer (SCC). Just like in nearly 100% of cervical cancer, infection with human papillomavirus (HPV) high-risk types causes more than 80% of anal cancer. Nevertheless the natural history of anal cancer is not fully understood. It mostly arises from high-grade squamous intraepithelial lesion (HSIL) resp. anal intraepithelial neoplasia (AIN) . In human immunodeficiency virus (HIV)-positive men having sex with men (MSM), the prevalence of anal HPV infection is especially high (45–95%). These patients have an increased risk of anal intraepithelial neoplasia (AIN), the putative precursor of anal SCC29. The prevalence of anal SCC is increasing steadily, reaching 35 per 100 000 in HIV-negative and 135 to 225 per 100 000 in HIV-positive MSM respectively. Today, anal SCC in HIV-positive MSM is over nine times more common than cervical cancer in women and has become the most common non-AIDS defining malignancy in HIV-positive patients10,11. In view of the increasing health burden of anal cancer in HIV positive MSM and its similarities to cervical cancer, an anal cancer screening programme is recommended for this Population.
The identification of early-stage cancer, when
treatment is most effective, is the basis for all surveillance
recommendations. The standard for AIN screening is high resolution
anoscopy (HRA) with a colposcope routinely used by gynaecologists in
combination with staining with acetic acid/lugol iodine, biopsies
and histopathological workup of suspicious lesions. The use of the
colposcope in AIN detection has a historical tradition since
premalignant cervical lesions have many similarities to AIN.
|type of project||clinical studies|
|status||ongoing - recruiting phase|
|start of project||2017|
|end of project||2019|
|study design||Prospective single centre study with randomised cross-over design|
|responsible person||Baumeler Stephan|