Abstract
Anal dysplasia and intraepithelial neoplasia are part of a continuum of anal cancer that is typically treated with curative intent. Surveillance after treatment in our practice includes high-resolution anoscopy. This is similar to colposcopy in cervical cancer screening and treatment programs. It allows for the visualization of the anal canal, with biopsy of suspicious looking lesions [1]. In Canada, high-resolution anoscopy is performed in a few outpatient settings, and constitutes part of a screening program for individuals who are at high risk for anal dysplasia due to human papillomavirus (e.g., men who have sex with men and HIV-positive individuals). These high-risk individuals are usually screened with an anal Pap smear, and referred for high-resolution anoscopy if the cytology result is abnormal. Following high-resolution anoscopy, biopsy may be indicated. If the biopsy shows high-grade dysplasia (anal intraepithelial neoplasia II/III, carcinoma in situ), lesions are treated with either 80 % trichloroacetic acid or infrared coagulation. Recent data on infrared coagulation show that it is a safe and effective office-based procedure, and that repeated treatments lead to resolution of the high-grade dysplasia [2].
Keywords
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Jay N, Berry JM, Hogeboom CJ, et al. Colposcopic appearance of anal squamous intraepithelial lesions: relationship to histopathology. Dis Colon Rectum. 1997;40:919–28.
Goldstone SE, Hundert JS, Huyett JW. Infrared coagulator ablation of high-grade anal squamous intraepithelial lesions in HIV-negative males who have sex with males. Dis Colon Rectum. 2007;50:565–75.
Pineda CE, Berry JM, Jay N, et al. High-resolution anoscopy targeted surgical destruction of anal high-grade squamous intraepithelial lesions: a ten-year experience. Dis Colon Rectum. 2008;51:829–37.
Foo M, Harrow S, Ma R, et al. Outcomes and treatment following recurrence of anal carcinoma after radical radiotherapy: the British Columbia experience. Radiother Oncol. 2010;96 Suppl 2:S44 (Abstr. 133).
Eeson G, Foo M, Harrow S, et al. Outcomes of salvage surgery for epidermoid carcinoma of the anus following failed combined modality treatment. Am J Surg. 2011;201:624–9.
Newman G, Calverly DC, Acker BD, et al. The management of carcinoma of the anal canal by external beam radiotherapy, experience in Vancouver 1971–1988. Radiother Oncol. 1992;25:196–202.
Cummings BJ, Keane TJ, O’Sullivan B, et al. Epidermoid anal cancer: treatment by radiation alone or radiation and 5-Fluorouracil with and without Mitomycin C. Int J Radiat Oncol Biol Phys. 1991;21:1115–25.
Schwarz JK. Siegel BA. Dehdashti F. et al.Tumor response and survival predicted by post-therapy FDG-PET/CT in anal cancer. Int J Radiat Oncol Biol Phys. 2008;71(1):180–86.
Day FL, Link E, Ngan S et al. FDG-PET metabolic response predicts outcomes in anal cancer managed with chemoradiotherapy. Br J Cancer. 2011;105:498–504.
Ajani AJ, Winter KA, Gunderson L, et al. Fluorouracil, Mitomycin and radiotherapy vs Fluorouracil, Cisplatin and radiotherapy for carcinoma of the anal canal. A randomized controlled trial. JAMA. 2008;299:1914–21.
Belkacemi Y, Berger C, Poortmans P, et al. Management of primary anal canal adenocarcinoma: a large retrospective study from the Rare Cancer Network. Int J Radiat Oncol Biol Phys. 2003;56: 1274–83.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Humana Press
About this chapter
Cite this chapter
Press, N., Hay, J. (2013). Anal Carcinoma Surveillance Counterpoint: Canada. In: Johnson, F., et al. Patient Surveillance After Cancer Treatment. Current Clinical Oncology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60327-969-7_41
Download citation
DOI: https://doi.org/10.1007/978-1-60327-969-7_41
Published:
Publisher Name: Humana Press, Totowa, NJ
Print ISBN: 978-1-60327-968-0
Online ISBN: 978-1-60327-969-7
eBook Packages: MedicineMedicine (R0)