Paul Rider1, John Hunter2, Leander Grimm2. 1. Department of Surgery, Division of Colon and Rectal Surgery, University of South Alabama, 2451 USA Medical Center Drive, Mastin Building, Suite 702, Mobile, AL, 36617, USA. prider@health.southalabma.edu. 2. Department of Surgery, Division of Colon and Rectal Surgery, University of South Alabama, 2451 USA Medical Center Drive, Mastin Building, Suite 702, Mobile, AL, 36617, USA.
Abstract
PURPOSE OF REVIEW: No single modality of care serves as the defined best practice for the treatment of anal intraepithelial neoplasia (AIN). This review aims to present the common treatment modalities germane to AIN while considering evolving evidence. RECENT FINDINGS: AIN affords an opportunity to evaluate and treat patients before the development of invasive diseases. Efforts to screen for AIN have yielded mixed results. The major available pharmacotheraputic and surgical options offer efficacious options to reduce the bioburden of disease but can be met with high levels of recurrent disease. None affords a predictably durable response in severe disease. Vaccination as primary prevention will likely reduce the overall upward trend in AIN. Evidence suggests vaccination also affords improvement in recurrent disease. Early evidence reveals potential benefit in multimodal approaches to control AIN. Valuable data is anticipated from the phase III, randomized ANCHOR study evaluating the management of high-grade AIN in HIV +patients.
PURPOSE OF REVIEW: No single modality of care serves as the defined best practice for the treatment of anal intraepithelial neoplasia (AIN). This review aims to present the common treatment modalities germane to AIN while considering evolving evidence. RECENT FINDINGS: AIN affords an opportunity to evaluate and treat patients before the development of invasive diseases. Efforts to screen for AIN have yielded mixed results. The major available pharmacotheraputic and surgical options offer efficacious options to reduce the bioburden of disease but can be met with high levels of recurrent disease. None affords a predictably durable response in severe disease. Vaccination as primary prevention will likely reduce the overall upward trend in AIN. Evidence suggests vaccination also affords improvement in recurrent disease. Early evidence reveals potential benefit in multimodal approaches to control AIN. Valuable data is anticipated from the phase III, randomized ANCHOR study evaluating the management of high-grade AIN in HIV +patients.
Entities:
Keywords:
AIN; Anal intraepithelial neoplasia; HPV; Human papilloma virus
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