Valutazione del ruolo e dell’efficacia dell’anoscopia ad alta risoluzione (HRA) come strumento di screening delle precancerosi anali e di diagnosi precoce del cancro anale nelle popolazioni ad alto rischio

Following abnormal cytologic results, high resolution anoscopy with biopsy is considered the gold standard for the diagnosis of high-grade lesions. We present the results of our experience with high resolution anoscopy in the diagnosis of anal intraepithelial neoplasia in a high-risk group of patients. Prospectively collected data of patients undergoing to HRA during a 3-year period were retrospectively analyzed. Histological results were recorded and a comparison between the clinico-pathological features of patients following biopsy was performed. The improvement in diagnostic efficacy among different period of study was also evaluated. HRA was performed for suspected lesions. The majority of cases were men who have sex with men infected with human immunodeficiency virus. The incidence rates of high-grade lesions and squamous cell cancer were reported. A significative correlation between cytologic and histologic HSIL was recorded (p <0.01) between patients with low-grade and high-grade lesions. High resolution anoscopy with biopsy allows the detection of precancerous lesions following abnormal cytologic screening in high risk group of patients. Extensive training of both anoscopist and pathologist in experienced centers is warranted.