Anal intraepithelial neoplasia

Authors: F. Abbasakoor; P. B. Boulos

Source: British Journal of Surgery, Volume 92, Number 3, March 2005 , pp. 277-290(14)

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Abstract:

Background:

Anal intraepithelial neoplasia (AIN) is believed to be a precursor of anal squamous cell cancer and its incidence is rising in high-risk groups, particularly those infected with the human immunodeficiency virus (HIV). The natural history of AIN is unclear and management strategies are lacking.

Methods:

This review is based on a literature search (Medline and PubMed) with manual cross-referencing of all articles related to AIN.

Results and conclusions:

The aetiology of AIN is intricately linked with human papilloma viruses. The pathological processes involved in the progression of AIN are becoming clearer but the natural history, particularly the rate of progression to invasive cancer, remains unknown. There is no standard management for AIN and this is mainly due to difficulties in both diagnosis and treatment. A variety of treatment options have been tried with varying success. Surgery is associated with significant recurrence, particularly in HIV-positive patients. Non surgical approaches with imiquimod, photodynamic therapy and vaccination are appealing, and further work is required. Long-term follow-up of these patients is essential until the natural history of AIN becomes clearer. Copyright © 2005 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

Document Type: Review article

DOI: http://dx.doi.org/10.1002/bjs.4967

Affiliations: 1: Department of Surgery, Royal Free and University College Medical School, London, UK

Publication date: 2005-03-01

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Anal intraepithelial neoplasia

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