{"id":45907,"date":"2023-08-01T07:32:38","date_gmt":"2023-08-01T07:32:38","guid":{"rendered":"https:\/\/i-base.info\/htb\/?p=45907"},"modified":"2023-08-15T12:38:08","modified_gmt":"2023-08-15T12:38:08","slug":"1-in-5-risk-of-missing-precancerous-lesions-if-only-hsil-are-biopsied","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/45907","title":{"rendered":"Anal cancer: 1 in 5 risk of missing precancerous lesions if only HSIL are biopsied"},"content":{"rendered":"
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Simon Collins, HIV i-Base<\/strong><\/p>\n<\/div>\n

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A poster from researchers at the\u00a0AIDS Clinical Center in Shinjuku-ku, Japan identifies a high risk of missing precancerous lesions due to the current approach to only biopsy lesions that are judged as HSIL after high-resolution anoscopy (HRA). [1]<\/span><\/strong><\/p>\n<\/div>\n

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From June 2021 to September 2022, the group\u00a0reanalysed samples from 673 lesions from 122 individuals using sextant biopsies.<\/span><\/p>\n<\/div>\n

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This collected at least six lesion samples in all directions regardless of abnormal findings from HRA.<\/span><\/p>\n<\/div>\n

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The prevalence of HSIL was 81.3%(91\/112) for individuals and 43.5%(293\/673) for lesions.<\/span><\/p>\n<\/div>\n

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The rate of the biopsy-proven HSIL that was predicted as LSIL was 36.5%(107\/293) for each lesion and 19.8%(18\/73) for each individual.<\/span><\/p>\n<\/div>\n

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The authors concluded that approximately 1 in 5 HSIL cases were considered low-risk lesions based on their appearance and that these results might explain cases of recurrence after treatment.<\/span><\/p>\n

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A prospective, longitudinal Spanish study in 493 gay men living with HIV reported an approximate 5% annual risk of progression from low- to high-grade lesions over a median of 43 months (IQR:12 to 76) follow-up between May 2010 and December 2021. [2]<\/span><\/p>\n<\/div>\n

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Risk factors for progression included acquiring high-risk HPV genotypes (HR: 4.15; IC 95%: 1.14 to 15.03), low-risk HPV genotypes (HR: 3.68 IC95%: 1.04 to 12.94), in particular genotype 6 (HR:4.47, IC95%: 1.34 to 14.91) and history of AIDS (HR: 5.81, 95%CI: 1.78 to 18.92).<\/span><\/p>\n<\/div>\n

comment<\/h3>\n

This study shows the importance of biopsy for any suspected lesion – and that it is essential even when a lesion might look harmless.<\/strong><\/p>\n

Some services might have even higher rates of false negative results depending on the experience of the anoscopist.<\/strong><\/p>\n

Currently, however, the lack a proper screening service in the UK means that most cases of HSIL are not being detected.<\/strong><\/p>\n

The US CDC are planning to updated guidance and will be interesting to see their recommendations for DARE +\/\u2013 anal cytology +\/\u2013 hrHPV testing, and at what ages in different populations.<\/strong><\/p>\n<\/div>\n

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Reference<\/p>\n<\/div>\n

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  1. Ando N et al. Standard biopsy with high-resolution anoscopy could miss potentially precancerous lesions. IAS 2023, poster abstract EPB0135.
    \n<\/span>https:\/\/programme.ias2023.org\/Abstract\/Abstract\/?abstractid=1427<\/span><\/a><\/li>\n
  2. \n
    \n

    Tenorio CH et al. Role of low-risk HPV PCR in screening for HSIL lesions and anal cancer in men who have sex with men (MSM) living with HIV (MSM-LWHIV). IAS 2023, poster abstract EPB0129.
    \n<\/span>    https:\/\/programme.ias2023.org\/Abstract\/Abstract\/?abstractid=276<\/a><\/p>\n<\/div>\n<\/li>\n<\/ol>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

    Simon Collins, HIV i-Base A poster from researchers at the\u00a0AIDS Clinical Center in Shinjuku-ku, Japan identifies a high risk of missing precancerous lesions due to the current approach to only biopsy lesions that are judged as HSIL after high-resolution anoscopy …<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4,18],"tags":[329],"class_list":["post-45907","post","type-post","status-publish","format-standard","hentry","category-conference-reports","category-cancer-and-hiv","tag-ias-2023"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/45907","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=45907"}],"version-history":[{"count":13,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/45907\/revisions"}],"predecessor-version":[{"id":46126,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/45907\/revisions\/46126"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=45907"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=45907"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=45907"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}