Anal squamous cell carcinoma is relatively rare in the general population but very much on the rise in certain populations including human immunodeficiency virus (HlV)-positive men and women, men who have sex with men (MSM), patients immunosuppressed for other reasons including solid organ transplant or autoimmune disease, and women with multifocal lower genital tract squamous intraepithelial neoplasia
. The American Cancer Society's estimates for anal cancer in the United States for 2017 are approximately 8200 new cases with about 1100 deaths (650 women and 450 men).
Caption: Cervical squamous intraepithelial neoplasia
3 is shown on a cervical gland.
Stages of anal cell abnormalities * Normal anal all * Atypical squamouscells of undetermined significance * Low-grade squamous Intraepithellal neoplasia * Atypical squamouscellls,cannot exclude HSIL * High-grade squamous intraepithelial neoplasia
* Invasive anal cancer Figure 2.
Additionally, women who present high grade vulvar squamous intraepithelial neoplasia
, vulvar cancer or cervical cancer must be part of this group, which corresponds to the absolute indications for anal cytology (Box 2).
Screening cytology carries a high specificity for detecting high-grade and low-grade squamous intraepithelial neoplasia
(HSIL and LSIL), which leads to proper treatment.
Frequency of occult high-grade squamous intraepithelial neoplasia
and invasive cancer within anal condylomata in men who have sex with men.
(22) Among men, risk factors for anal squamous intraepithelial neoplasia
include HPV infection, as well as higher numbers of male partners for receptive anal intercourse in the previous 6 months, and the use of illegal drugs, such as alkyl nitrites and injection drugs.
On cytology, squamous intraepithelial neoplasia
and VAIN "look exactly the same," he added.
The World Health Organization (WHO) 2017 classification formally reused the term dysplasia, (2) rather than the previously proposed terms squamous intraepithelial neoplasia
(SIN), (3,4) squamous intraepithelial lesion (SIL), (5) or laryngeal intraepithelial neoplasia.
Eosinophilic dysplasia of the cervix: a newly recognized variant of cervical squamous intraepithelial neoplasia
. Am I Surg Pathol.
of Positive for Follow-up Diagnosis Women Aptima HPV, % Cytology only Normal 189 57 LSIL 18 78 ASCUS 5 80 Total 212 59 Histology Normal 35 57 CIN 1 91 69 CIN 2 34 91 CIN 3 31 94 Adenocarcinoma in situ 1 100 Adenocarcinoma 1 100 Total 193 75 Abbreviations: ASCUS, atypical squamous cells of undetermined significance; CIN, cervical squamous intraepithelial neoplasia
; HPV, human papillomavirus; LSIL, low-grade squamous intraepithelial lesion.