500 results match your criteria Anoscopy


Xpert HPV as a Screening Tool for Anal Histologic High-Grade Squamous Intraepithelial Lesions in Women Living With HIV.

J Acquir Immune Defic Syndr 2021 Jul;87(3):978-984

Weill Department of Medicine, Division of Infectious Diseases, Weill Cornell Medicine, New York, NY.

Background: Women living with HIV (WLWH) experience high rates of anal cancer. Screening using anal cytology, high-resolution anoscopy (HRA) with biopsies, can histologically diagnose anal cancer precursors called high-grade squamous intraepithelial lesions (HSIL). The low specificity of screening using anal cytology results in HRA referral for many WLWH without HSIL. Read More

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"That's Only for Women": The Importance of Educating HIV-Positive Sexual Minority Men on HPV and High Resolution Anoscopy (HRA).

J Int Assoc Provid AIDS Care 2021 Jan-Dec;20:23259582211016134

Department of Gynecology and Obstetrics; 12239Emory University School of Medicine, Atlanta, GA, USA.

Gay, bisexual, and other men who have sex with men (MSM) experience disproportionately high burdens of Human Papilloma Virus (HPV)-associated anal cancers. Recent focus has shifted to anorectal cancer prevention through high-resolution anoscopy (HRA); however, little is known about sexual minority men's perceptions, attitudes, or beliefs regarding HRA. We conducted 4 qualitative Focus Group Discussions (FGDs) (n = 15) with sexual minority men, focusing on their beliefs, attitudes, and perceptions of undergoing HRA. Read More

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Comparison of two sample collection devices for anal cytology in HIV- positive men who have sex with men: Cytology-brush and Dacron-swab.

Cytopathology 2021 May 25. Epub 2021 May 25.

HIV and STD Unit (Infectious Disease Service), Bellvitge University Hospital / Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.

Objective: HIV-positive men who have sex with men (MSM) are a vulnerable group for anal cancer (AC), a cancer with a well-described precursor lesion, which can be early detected in screening programs using anal liquid-based cytology (aLBC). We aim to compare two aLBC sample collection devices: cytology-brush (CB) and Dacron- swab (DS).

Methods: Retrospective analysis of two consecutive study-periods, the first using CB and the second DS. Read More

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The other side of screening: predictors of treatment and follow-up for anal precancers in a large health system.

AIDS 2021 May 19. Epub 2021 May 19.

Division of Infectious Diseases, Department of Medicine Department of Medical Education Department of Pathology Division of General Internal Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA Department of Management, Policy and Community Health, University of Texas School of Public Health, Houston, TX, USA.

Background: Anal cancer disproportionately affects people with HIV (PWH). High-grade squamous intraepithelial lesions (HSIL) are cancer precursors and treating might prevent anal cancer. Data on adherence to HSIL treatment and surveillance is limited but needed to identify deficiencies of screening strategies. Read More

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High prevalence of anal high-grade squamous intraepithelial lesions, and prevention through human papillomavirus vaccination, in young men who have sex with men living with HIV.

Clin Infect Dis 2021 May 15. Epub 2021 May 15.

Department of Pediatrics, Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine, Cincinnati, OH, USA.

Background: Men who have sex with men (MSM) are at high risk for HPV-related anal cancer. Little is known about the prevalence of low-grade squamous intraepithelial lesions (LSIL) and the anal cancer precursor, high-grade squamous intraepithelial lesions (HSIL), among young MSM living with HIV (MSMLWH). HPV vaccination is recommended in this group but its safety, immunogenicity and protection against vaccine-type HPV infection and associated LSIL/HSIL have not been studied. Read More

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Response factors associated with electrocautery treatment of intra-anal high-grade squamous intraepithelial lesions in a population of HIV-positive men who have sex with men.

Int J STD AIDS 2021 May 12:9564624211017005. Epub 2021 May 12.

Department of Infectious Diseases, 16493Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain.

Background: Ablative treatment of anal high-grade squamous intraepithelial lesions (HSIL) reduces the risk of progression to anal squamous cell carcinoma.

Objectives: To identify factors that influence the response to treatment of anal HSIL by electrocautery ablation (ECA) in a population of HIV-positive men who have sex with men (MSM).

Design: Retrospective study of ECA treatment response in a prospectively followed anal dysplasia cohort. Read More

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HPV vaccination to prevent recurrence of Anal Intraepithelial Neoplasia in HIV+ MSM: a randomised, placebo-controlled multicentre trial.

AIDS 2021 May 5. Epub 2021 May 5.

Department of Dermatology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands Department of Internal Medicine, Division of Infectious Diseases, Amsterdam Institute for Infection and Immunity (AII), Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands Department of Pathology, Cancer Center Amsterdam (CCA), Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands Department of Infectious Diseases, Public Health Service of Amsterdam (GGD Amsterdam), Amsterdam, The Netherlands Department of Dermatology, OLVG, Amsterdam, The Netherlands DC Klinieken Lairesse, Amsterdam, The Netherlands Department of Pathology, Cancer Center Amsterdam (CCA), Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands DDL Diagnostic Laboratory, Rijswijk, The Netherlands Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands Department of Epidemiology and Data Science, Amsterdam Public Health Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands STI Outpatient Clinic, Department of Infectious Diseases, Public Health Service of Amsterdam (GGD Amsterdam), Amsterdam, The Netherlands. Authors contributed equally.

Objective: Anal cancer precursor lesions high-grade anal intraepithelial neoplasia (HGAIN) are highly prevalent among HIV+ men-who-have-sex-with-men (MSM). Treatment of HGAIN is frustrated by high recurrence rates. We investigated the efficacy of the quadrivalent human papillomavirus (qHPV) vaccine as post-treatment adjuvant in preventing HGAIN recurrence in HIV+MSM. Read More

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Intestinal Dysbiosis Disguised as a Rectal Fistula Treated With Autologous Fecal Microbiota Transplantation.

Cureus 2021 Mar 25;13(3):e14115. Epub 2021 Mar 25.

Gastroenterology, Grand Strand Medical Center, Myrtle Beach, USA.

Fecal microbiota transplantation (FMT) has been efficacious in the treatment of intestinal dysbiosis, derangement of the native intestinal microflora, and the indications for autologous FMT are growing. A 69-year-old Caucasian man with a past medical history of paraplegia secondary to motor vehicle accident and sigmoid-end colostomy presented to his gastroenterologist with the complaint of rectal discharge. A complicated medical course pre-dated his presentation and included multiple decubitus ulcers requiring debridement and several courses of broad-spectrum antibiotics. Read More

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High-Resolution Anoscopy-Based Anal Cancer Surveillance and Women.

Dis Colon Rectum 2021 Jun;64(6):e378

Department of Oncology and Hematology, Kaiser Permanente Oakland Medical Center, Oakland, California.

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State of the Science: Screening, Surveillance, and Epidemiology of HPV-Related Malignancies.

Am Soc Clin Oncol Educ Book 2021 Mar;41:1-12

Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.

Oropharyngeal, cervical, vulvar, and anal cancers share a common risk factor of HPV infection. HPV vaccination is currently recommended at age 11 or 12 to prevent new HPV infections for all genders with catch-up vaccination recommened up to age 26. Despite the known effectiveness of HPV vaccination to prevent HPV-related cancer, there is continued low uptake in the United States; only 40% of eligible persons were vaccinated in 2018, though rates are 70% among teenagers. Read More

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Anal cancer screening and prevention: a review for dermatologists.

J Eur Acad Dermatol Venereol 2021 Apr 2. Epub 2021 Apr 2.

Department of Dermatology, Vagelos College of Physicians & Surgeons, Columbia University, New York, NY, USA.

The incidence of and mortality from anal cancer, predominantly squamous cell carcinoma (SCC), have been increasing since the 1980s, during an era when many common malignancies have seen decreases in mortality. Dermatologists may be more likely to see patients at an increased risk for anal SCC, such as those living with HIV, MSM and those presenting for management of anogenital warts, yet there is little guidance in the field on how to manage these patients. We underwent a project to review the evidence surrounding screening and prevention of anal SCC. Read More

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A Multi-Institutional Phase 2 Trial of High-Dose SAbR for Prostate Cancer Using Rectal Spacer.

Int J Radiat Oncol Biol Phys 2021 Mar 19. Epub 2021 Mar 19.

Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas.

Purpose: High-dose SABR for prostate cancer offers the radiobiologic potency of the most intensified radiation therapy regimens but was associated with >90% rates of ulceration of the anterior rectal wall on endoscopic assessment; this infrequently progressed to severe rectal toxicity in prior prospective series. A multi-institutional phase 2 prospective trial was conducted to assess whether placement of a perirectal hydrogel spacer would reduce acute periprostatic rectal ulcer events after high-dose (>40 Gy) SABR.

Methods And Materials: Eligible patients included men with stage ≤T2c localized grade group 1 to 3 prostate cancer, a prostate-specific antigen (PSA) level ≤15 ng/mL, American Urological Association Symptom Index = AUA-SI scores ≤18, and a gland volume ≤80 cm. Read More

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Levator ani and puborectalis muscle rupture: diagnosis and repair for perineal instability.

Tech Coloproctol 2021 Mar 20. Epub 2021 Mar 20.

Proctology Unit and Pelvic Floor Unit, Division of Digestive Surgery, Department of Surgery, Geneva University Hospitals and Medical School, 4 rue Gabrielle-Perret-Gentil, 1211, Geneva, Switzerland.

Background: Puborectalis muscle rupture usually arises from peri-partum perineal trauma and may result in anterior, middle compartment prolapses, posterior compartment prolapse which includes rectocele and rectal prolapse, with or without associated anal sphincter damage. Patients with puborectalis muscle and levator ani rupture may present some form of incontinence or evacuation disorder, sexual dysfunction or pelvic organ descent. However, the literature on this subject is scarce. Read More

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Anal cancer and precancerous lesions: a call for improvement.

Lancet Gastroenterol Hepatol 2021 04;6(4):327-334

CINTESIS - Center for Health Technology and Services Research, Medical Research Center, University of Porto, Porto, Portugal; Gastroenterology Department, Portuguese Oncology Institute of Porto, Porto, Portugal.

Anal squamous cell carcinoma is the most common type of anal cancer and is largely associated with anal human papillomavirus infection. The incidence of anal squamous cell carcinoma is increasing, and although still uncommon in the general population, a high incidence has been noted in specific population groups (eg, patients with HIV, men who have sex with men [MSM], recipients of solid organ transplants, women with genital neoplasia, and patients with systemic lupus erythematosus or inflammatory bowel disease). The higher incidence among individuals who are HIV-positive makes anal squamous cell carcinoma one of the most common non-AIDS-defining cancers among HIV-positive individuals. Read More

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Electroejaculation in men with spinal cord injury: a step-by-step video demonstration.

Fertil Steril 2021 May 10;115(5):1344-1346. Epub 2021 Mar 10.

Department of Urology, University of Miami, Miller School of Medicine, Miami, Florida.

Objective: To demonstrate the proper technique to perform electroejacuation (EEJ) in men with spinal cord injury (SCI) for the purpose of inducing ejaculation.

Design: A video demonstration of the proper technique to perform EEJ in men with SCI using the Seager model 14 electroejaculation machine.

Setting: Major university medical center. Read More

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Factors associated with rectal pH among men who have sex with men.

Sex Health 2021 May;18(2):140-146

Amsterdam UMC, University of Amsterdam, Department of Dermatology, Amsterdam Institute for Infection and Immunity, Academic Medical Centre & STI Outpatient Clinic, Department of Infectious Diseases, Public Health Service Amsterdam, The Netherlands.

Background Rectal chlamydia treatment failures up to 22% with azithromycin 1 g have been reported, but low tissue concentrations are unlikely to be the cause. Anecdotally, low rectal pH could reduce rectal azithromycin concentrations, with in vitro studies reporting higher minimum inhibitory concentrations (MICs) with lower pHs for antibiotics used to treat sexually transmissible infections (STIs). Leucocytes arising from an inflammatory immune response could also lower pH and efficacy. Read More

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Incidence of Recurrent High-Grade Anal Dysplasia in HIV-1-Infected Men and Women Following Infrared Coagulation Ablation: A Retrospective Cohort Study.

Pathogens 2021 Feb 14;10(2). Epub 2021 Feb 14.

Lluita contra la Sida Foundation, Hospital Universitari Germans Trias i Pujol, Carretera de Canyet, s/n, Badalona, 08916 Barcelona, Spain.

This single-center, retrospective cohort study sought to estimate the cumulative incidence in HIV-1-infected patients of biopsy-proven high-grade anal intraepithelial neoplasia (HGAIN) recurrence after infrared coagulation (IRC) treatment. The study was based on data from a prospectively compiled database of 665 HIV-1-infected outpatients who attended a hospital Clinical Proctology/HIV Unit between January 2012 and December 2015. Patient records were checked to see which ones had received IRC treatment but later experienced a recurrence of HGAIN. Read More

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February 2021

Knowledge, Attitudes, and Experiences of Anal Cancer and Anal Cancer Screening Among a Clinical Sample of Hispanic Women.

J Low Genit Tract Dis 2021 Apr;25(2):98-105

Department of Obstetrics and Gynecology, School of Medicine, University of Puerto Rico.

Objective: Anal cancer screening has been recommended for women with lower genital tract neoplasia, lupus, Crohn disease, HIV, and/or organ transplantation recipients. This study described and compared knowledge, attitudes, and experiences related to anal cancer and anal cancer screening between women at high risk for anal cancer and their counterparts.

Methods: This is a cross-sectional study within colposcopy and gynecology oncology clinics in Puerto Rico; 278 women 21 years or older and with prior diagnosis of gynecological neoplasia completed an interviewer-administered questionnaire. Read More

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Outcomes of radiofrequency ablation for anal high-grade squamous intraepithelial lesions.

Tech Coloproctol 2021 06 15;25(6):701-707. Epub 2021 Feb 15.

Department of Colon and Rectal Surgery, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Tlalpan, 14000, Mexico City, Mexico.

Background: Radiofrequency ablation (RFA) of high-grade squamous intraepithelial lesions (HSIL) is a promising minimally invasive technique but its oncologic and functional outcomes are not well studied. The primary outcome was the efficacy of RFA, and the secondary outcomes were the functional and anatomical anal changes related to RFA.

Methods: This was a retrospective analysis of our prospectively collected database of patients who had RFA for HSIL at our institution, between August 2018 and March 2020. Read More

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Feasibility and safety study of a high resolution wide field-of-view scanning endoscope for circumferential intraluminal intestinal imaging.

Sci Rep 2021 Feb 11;11(1):3544. Epub 2021 Feb 11.

Department of Gastroenterology, City of Hope, Duarte, CA, USA.

Global anal cancer incidence is increasing. High resolution anoscopy (HRA) currently screens for anal cancer, although the definitive test remains unknown. To improve on intraluminal imaging of the anal canal, we conducted a first-in-human study to determine feasibility and safety of a high-resolution, wide field-of-view scanning endoscope. Read More

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February 2021

High-resolution anoscopy, is there a benefit in proceeding directly to the operating room?

Tech Coloproctol 2021 04 10;25(4):461-466. Epub 2021 Feb 10.

Department of Surgery, Ravitch Division of Colon and Rectal Surgery, High Resolution Anoscopy Clinic, The Johns Hopkins Hospital, Johns Hopkins University School of Medicine, 600 N. Wolfe St., Blalock 618, Baltimore, MD, 21287, USA.

Background: The development of high-resolution anoscopy (HRA) has advanced our ability to detect anal dysplasia. Historically, HRA is performed in a clinical setting and subsequent ablation is performed in the clinical setting or operating room. The aim of this study was to determine the most effective venue for the performance of HRA. Read More

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Exploiting the Microbiota for the Diagnosis of Anal Precancerous Lesions in Men Who Have Sex With Men.

J Infect Dis 2021 Feb 5. Epub 2021 Feb 5.

Department of Infectious Diseases, Hospital Universitario Ramon y Cajal, Facultad de Medicina, Universidad de Alcalá, IRYCIS, Madrid, Spain.

Background: While the microbiota has been associated with HPV malignant transformation, it is unclear whether anal bacteria could improve the low specificity of anal cytology for the screening of high grade intraepithelial squamous neoplasia (HSIL).

Methodology: We recruited MSM undergoing anal cytology and high-resolution anoscopy. We assessed the microbiota composition from fecal samples and cytobrush anal samples using 16SrDNA sequencing in subjects with and without biopsy-proven HSIL (bHSIL). Read More

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February 2021

Risk factors for ≥high-grade anal intraepithelial lesions in MSM living with HIV and the response to topical and surgical treatments.

PLoS One 2021 3;16(2):e0245870. Epub 2021 Feb 3.

Internal Medicine Department, Marina Baixa Hospital, Alicante, Spain.

Background: The objective of this study in MSM living with HIV was to determine the incidence of HSIL and ASCC, related factors, and the response to treatment.

Patients And Methods: Data were gathered in 405 consecutive HIV-infected MSM (May 2010-December 2018) at baseline and annually on: sexual behavior, anal cytology, and HPV PCR and/or high-resolution anoscopy results. They could choose mucosectomy with electric scalpel (from May 2010) or self-administration of 5% imiquimod 3 times weekly for 16 weeks (from November 2013). Read More

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February 2021

Effectiveness of the Quadrivalent HPV Vaccine in Preventing Anal ≥ HSILs in a Spanish Population of HIV+ MSM Aged > 26 Years.

Viruses 2021 Jan 20;13(2). Epub 2021 Jan 20.

Infectious Disease Department, Hospital Universitario Virgen de las Nieves Granada, 18014 Granada, Spain.

Anal squamous cell carcinoma is the most frequent virus-related non-AIDS-defining neoplasia among HIV-infected individuals, especially MSM. The objectives of this study were to analyze the effectiveness of the quadrivalent HPV (qHPV) vaccine to prevent anal ≥ high-grade squamous intraepithelial lesions (≥HSILs), external ano-genital lesions (EAGLs), and infection by qHPV vaccine genotypes in HIV+ MSM, and to study the immunogenicity of the vaccine and risk factors for ≥ HSILs. This study is nested within a randomized, double-blind, placebo-controlled trial of the qHPV vaccine, which enrolled participants between May 2012 and May 2014, with a 48-month follow-up. Read More

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January 2021

[Value of high-resolution anoscopy in the diagnosis of anal precancerous lesions].

Zhonghua Fu Chan Ke Za Zhi 2021 Jan;56(1):34-42

Center for Diagnosis and Treatment of Cervical Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China.

To evaluate the value of high-resolution anoscopy (HRA) in the diagnosis of anal precancerous lesions. A retrospective cohort study was performed, which included 142 patients who underwent HRA in vulvar and anal clinic at Obstetrics and Gynecology Hospital of Fudan University from January 2014 to December 2019. With the perianal and anal canal biopsy pathology as the "gold standard", the diagnostic value of HRA and specific findings for anal precancerous lesions were evaluated and the clinical characteristics of patients with anal precancerous lesions were analyzed. Read More

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January 2021

Treatment of intra-anal warts with imiquimod 5% cream: A single-center prospective open study.

J Dermatol 2021 Apr 18;48(4):476-480. Epub 2021 Jan 18.

Department of Dermatology, Tokyo Medical University, Tokyo, Japan.

Intra-anal warts are frequently recalcitrant to surgical removal, but imiquimod 5% cream is not formulated to use in clinical practice due to the risk of mucosal inflammation. In the present, prospective, open study examining the efficacy and safety of imiquimod 5% cream, the drug was applied to the entire inner surface of the anal canal with a cotton swab under anoscopy three times weekly for 16 weeks. If complete remission was not achieved, the treatment was continued until week 28. Read More

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Analysis of the prevalence of human papillomavirus and abnormal anal cytology in women at risk.

J Obstet Gynaecol 2021 Jan 16:1-6. Epub 2021 Jan 16.

Obstetrics and Gynaecology Service, La Paz University Hospital, Madrid, Spain.

Our aim was to analyze the association between anal human papillomavirus (HPV) infection and abnormal anal cytology in women with high-grade cervical intraepithelial neoplasia (CIN 2+). We also analysed what other risk factors might be significant. We carried out a prevalence study from April 2015 to March 2017 at La Paz University Hospital. Read More

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January 2021

Low Perceived Anal Cancer Risk and Screening Utilization Among High-Risk Transgender Men and Women Living in an HIV / STI Epicenter.

AIDS Behav 2021 Jul 4;25(7):2210-2218. Epub 2021 Jan 4.

Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Miami Miller School of Medicine, 1611 NW 12th Avenue, Holtz East Tower #4070, Miami, FL, 33136, USA.

Although risk behaviors could place transgender people at increased risk of anal cancer, few studies have examined anal cancer knowledge and screening use among this population. This study assessed knowledge of anal cancer and associated screening tools, self-perceived risk for anal cancer, and willingness to undergo anal cytology testing among transgender persons in an HIV/sexually transmitted infection (STI)-dense region. Adult transgender persons were recruited locally and surveyed electronically. Read More

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Comparing Anal Cancer Screening Algorithms Using Cytology and HPV DNA Testing in Three High-risk Populations.

J Infect Dis 2021 Jan 3. Epub 2021 Jan 3.

Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

Background: Screening strategies for high-risk human papillomavirus (hrHPV)-associated anal cancer are evolving. This study compares the screening performance of anal cytology to hrHPV DNA testing and two novel cytology/hrHPV cotesting algorithms among three high-risk populations.

Methods: Anal cytology, hrHPV DNA testing, and high-resolution anoscopy (HRA)-guided biopsy results were analyzed from 1,837 participants comprising 1,504 HIV-infected men who have sex with men (MSM), 155 HIV-uninfected MSM, and 178 HIV-infected women. Read More

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January 2021