BACKGROUND: The risk of anal carcinoma after previous diagnosis of anal intraepithelial neoplasia III is unclear. OBJECTIVE: The purpose of this study was to estimate the risk of anal carcinoma in patients with anal intraepithelial neoplasia III and to identify predictors for subsequent malignancy. DESIGN: This was a retrospective review using the Surveillance, Epidemiology, and End Results registry (1973-2014). SETTING: The study was composed of population-based cancer registries from the United States. PATIENTS: Patients who were diagnosed with anal intraepithelial neoplasia III were included. MAIN OUTCOME MEASURES: The primary outcome was rate of subsequent anal squamous cell carcinoma. Predictors for anal cancer were identified using logistic regression and Cox proportional hazard models. RESULTS: A total of 2074 patients with anal intraepithelial neoplasia III were identified and followed for a median time of 4.0 years (interquartile range, 1.8-6.7 y). Of the cohort, 171 patients (8.2%) subsequently developed anal cancer. Median time from anal intraepithelial neoplasia III diagnosis to anal cancer diagnosis was 2.7 years (interquartile range, 1.1-4.5 y). Fifty-two patients (30.4%) who developed anal carcinoma were staged T2 or higher. Ablative therapies for initial anal intraepithelial neoplasia III were associated with a reduction in the risk of anal cancer (OR = 0.3 (95% CI, 0.1-0.7); p = 0.004). Time-to-event analysis revealed that the 5-year incidence of anal carcinoma after anal intraepithelial neoplasia III was 9.5% or ≈1.9% per year. LIMITATIONS: The registry did not record HIV status, surveillance schedule, use of high-resolution anoscopy, or provider specialty. CONCLUSIONS: In the largest published cohort of patients with anal intraepithelial neoplasia III, ≈10% of patients were projected to develop anal cancer within 5 years. Nearly one third of anal cancers were diagnosed at stage T2 or higher despite a previous diagnosis of anal intraepithelial neoplasia III. Ablative procedures were associated with a decreased risk of cancer. This study highlights the considerable rate of malignancy in patients with anal intraepithelial neoplasia III and the need for effective therapies and surveillance. See Video Abstract at http://links.lww.com/DCR/A764.
BACKGROUND: The risk of anal carcinoma after previous diagnosis of anal intraepithelial neoplasia III is unclear. OBJECTIVE: The purpose of this study was to estimate the risk of anal carcinoma in patients with anal intraepithelial neoplasia III and to identify predictors for subsequent malignancy. DESIGN: This was a retrospective review using the Surveillance, Epidemiology, and End Results registry (1973-2014). SETTING: The study was composed of population-based cancer registries from the United States. PATIENTS: Patients who were diagnosed with anal intraepithelial neoplasia III were included. MAIN OUTCOME MEASURES: The primary outcome was rate of subsequent anal squamous cell carcinoma. Predictors for anal cancer were identified using logistic regression and Cox proportional hazard models. RESULTS: A total of 2074 patients with anal intraepithelial neoplasia III were identified and followed for a median time of 4.0 years (interquartile range, 1.8-6.7 y). Of the cohort, 171 patients (8.2%) subsequently developed anal cancer. Median time from anal intraepithelial neoplasia III diagnosis to anal cancer diagnosis was 2.7 years (interquartile range, 1.1-4.5 y). Fifty-two patients (30.4%) who developed anal carcinoma were staged T2 or higher. Ablative therapies for initial anal intraepithelial neoplasia III were associated with a reduction in the risk of anal cancer (OR = 0.3 (95% CI, 0.1-0.7); p = 0.004). Time-to-event analysis revealed that the 5-year incidence of anal carcinoma after anal intraepithelial neoplasia III was 9.5% or ≈1.9% per year. LIMITATIONS: The registry did not record HIV status, surveillance schedule, use of high-resolution anoscopy, or provider specialty. CONCLUSIONS: In the largest published cohort of patients with anal intraepithelial neoplasia III, ≈10% of patients were projected to develop anal cancer within 5 years. Nearly one third of anal cancers were diagnosed at stage T2 or higher despite a previous diagnosis of anal intraepithelial neoplasia III. Ablative procedures were associated with a decreased risk of cancer. This study highlights the considerable rate of malignancy in patients with anal intraepithelial neoplasia III and the need for effective therapies and surveillance. See Video Abstract at http://links.lww.com/DCR/A764.
Authors: Benjamin P Crawshaw; Andrew J Russ; Sharon L Stein; Harry L Reynolds; Eric L Marderstein; Conor P Delaney; Bradley J Champagne Journal: Dis Colon Rectum Date: 2015-01 Impact factor: 4.585
Authors: Richard John Hillman; Tamzin Cuming; Teresa Darragh; Mayura Nathan; Michael Berry-Lawthorn; Stephen Goldstone; Carmella Law; Joel Palefsky; Luis F Barroso; Elizabeth A Stier; Céline Bouchard; Justine Almada; Naomi Jay Journal: J Low Genit Tract Dis Date: 2016-10 Impact factor: 1.925
Authors: Edgar P Simard; Meg Watson; Mona Saraiya; Christina A Clarke; Joel M Palefsky; Ahmedin Jemal Journal: Cancer Date: 2013-07-16 Impact factor: 6.860
Authors: Cristina B Sanger; Yiwei Xu; Evie Carchman; Elise H Lawson; Charles P Heise; Rob Striker; Corrine I Voils Journal: Dis Colon Rectum Date: 2021-07-01 Impact factor: 4.412
Authors: Danielle R L Brogden; Christopher C Khoo; Christos Kontovounisios; Gianluca Pellino; Irene Chong; Diana Tait; Oliver J Warren; Mark Bower; Paris Tekkis; Sarah C Mills Journal: Discov Oncol Date: 2021-02-11
Authors: Ramon P van der Zee; Olivier Richel; Carel J M van Noesel; Iuliana Ciocănea-Teodorescu; Annina P van Splunter; Timo J Ter Braak; Mayura Nathan; Tamzin Cuming; Michael Sheaff; Alexander Kreuter; Chris J L M Meijer; Wim G V Quint; Henry J C de Vries; Jan M Prins; Renske D M Steenbergen Journal: Clin Infect Dis Date: 2021-06-15 Impact factor: 9.079
Authors: D R L Brogden; C Kontovounisios; I Chong; D Tait; O J Warren; M Bower; P Tekkis; S C Mills Journal: Tech Coloproctol Date: 2021-06-12 Impact factor: 3.781