Anal dysplasia is a pre-cancerous condition which occurs when the mucosa lining of the anal canal undergo abnormal changes. During this condition, lesions or visible pattern of clustered abnormal cells appear. These cells may then progress from low-grade lesions to high-grade lesions.
Symptoms include genital and or anal warts in and around the anus. In some patients abnormalities in the lining of that anal region can occur without the presence of warts and any other symptoms .
Anal dysplasia is most commonly linked to Human Papilloma Virus (HPV) which is considered a sexually-transmitted disease. Roughly 80% of people who have had one or two lifetime sex partners and 100% of people who have had five lifetime sex partners have had HPV infection, thus HPV is extremely prevalent, particularly in young, sexually active populations. This original infection may resolve itself or may persist for life.
Anal cancer, like cervical cancer, is a member of a broader group of anogenital cancers known to be associated with sexually transmitted viral HPV infection. Anal cancer is rare in the general population but it is significantly more common in the HIV infected population, specifically in HIV-positive homosexual and bisexual men, where it presents at a rate of 70 per 100,000 men. Unfortunately, the risk for anal cancer is reported to be increasing dramatically in HIV-positive males and females, particularly since the introduction of highly active antiretroviral therapy in the mid-1990s. This is because people are living longer and some may continue to get newly exposed to other HPV viral strains.
Anal Dysplasia Screening
Anal Pap smear
An anal Pap smear is a very simple procedure performed by your medical provider as part of a routine physical evaluation.
The purpose of the Anal Pap smear is to check for anal cancer, but it can identify other changes in the anus that may show pre-cancerous conditions. It is recommended that HIV positive patients, patients with history of genital or anal warts, previous anal dysplasia, and women with abnormal cervical pap smears have this procedure done once a year.
The procedure takes only a couple of minutes. Your provider will insert a moist Q-tip into your anus and remove it slowly in a circular motion. The procedure is essentially painless, and rarely associated with little discomfort. It does not require special bowel cleansing. The sample is then sent to the laboratory where it is read by a pathologist. Results are available in approximately three weeks.
This test is very sensitive and about one half of the results may be reported as other than “Normal”. You may have one of the following results:
Normal. This is a normal test. As part of your medical care your provider may repeat the anal Pap every one or two years. You may not get a call from our office; however, the results will be discussed during your next scheduled appointment.
Unsatisfactory. The specimen is not adequate for evaluation by the laboratory. Your provider will repeat the anal Pap during your next scheduled visit.
ASCUS. (Atypical Cells of Undetermined Significance). Means that there were mild cellular changes and the cause is unknown. You will be called by our office to schedule a more in depth examination: High Resolution Anoscopy ( HRA ) and a possible biopsy.
Dysplasia. There are more noticeable changes in the cells that may indicate pre-cancerous conditions. You will be called by our office to schedule a more in depth examination: High Resolution Anoscopy ( HRA ) and a possible biopsy .
Infrared Coagulation (IRC)
IRC is a very simple and effective procedure to treat mild to moderate cases of anal dysplasia or warts of the anal canal. The procedure takes place in our office and has minimal discomfort to you. This procedure is done using High Resolution Anoscopy only after the diagnosis of dysplasia and or warts have been confirmed.