Clin Colon Rectal Surg 2018; 31(06): 336-346
DOI: 10.1055/s-0038-1668103
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

History of High-Resolution Anoscopy

S. David Cho
1   Department of Surgery, Kaiser Permanente, Portland, Oregon
,
Emily Groves
2   Department of General Surgery, Oregon Health and Science University, Portland, Oregon
,
Victoria V. Lao
3   Department of General Surgery, University of Washington, Seattle, Washington
› Author Affiliations
Further Information

Publication History

Publication Date:
02 November 2018 (online)

Abstract

High-resolution anoscopy (HRA) is a form of low-resolution anal microscopy currently utilized in the screening and management of anal squamous dysplasia. No randomized controlled trials, national or international guidelines exist on the use of HRA for this purpose. Much of our understanding of this entity has been adapted from the literature on cervical squamous dysplasia, including the technique of HRA itself. Epidemiologic evidence has shown that the prevalence and incidence of anal dysplasia is highest in HIV-positive populations. The history of this technique parallels the evolution of our understanding of anal dysplasia. To understand the history of the use of HRA and its place in the screening and management of anal squamous dysplasia, we discuss key advances in the understanding of human papillomavirus–related squamous dysplasia. We begin with early reports in the field establishing the link between this virus and squamous dysplasia, through the marked increase in anal cancer seen with the onset of the HIV epidemic, the identification of relevant populations at risk, the performance of the test itself, to its use today.

Photo Credits

Ami Multani, MD, Primary Care, Fenway Community Health Center, Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Instructor in Medicine, Harvard Medical School.


 
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