Abstract
While overall uncommon, the incidence of anal cancer in the United States is on the
rise. The majority of these cases are squamous cell in origin and attributed to infection
with human papillomavirus (HPV) and the associated evolution of anal squamous intraepithelial
lesions. Immunosuppressed patients such as those with human immunodeficiency virus
(HIV) or solid organ transplants and those with high-grade dysplasia or carcinoma
of the cervix or vulva are at highest risk for evolution to anal cancer. The recently
published anal cancer HSIL outcomes research (ANCHOR) trial demonstrated benefit to
treating anal high-grade squamous intraepithelial lesions (HSILs) to reduce the progression
to anal cancer. This article reviews screening and treatment of anal HSIL including
ablative, topical, and surgical options as well as the diagnosis and treatment of
anal cancer.
Keywords
HSIL - anal dysplasia - anal cancer - HPV
