Comparing and contrasting clinical consensus and guidelines for anal intraepithelial neoplasia in different geographical regions
Author(s)
Brogden, DRL
Lupi, MEE
Warren, OJ
Kontovounisios, C
Mills, SC
Type
Journal Article
Abstract
Anal Squamous Cell Carcinoma (ASCC) is an uncommon cancer with a recognised precursor Anal Intraepithelial Neoplasia (AIN). Although there are consistent evidence-based guidelines for the management of ASCC, historically this has not been the case for AIN and as a result there have been geographical variations in the recommendations for the treatment of AIN. More recently there have been updates in the literature to the recommendations for the management of AIN. To assess whether we are now closer to achieving an international consensus, we have completed a systematic scoping review of available guidelines for the screening, treatment and follow-up of AIN as a precursor to ASCC. MEDLINE and EMBASE were systematically searched for available clinical guidelines endorsed by a recognised clinical society that included recommendations on either the screening, treatment or follow-up of AIN. Nine clinical guidelines from three geographical areas were included. The most recent guidelines agreed that screening for AIN in high-risk patients and follow-up after treatment was necessary but there was less consensus on the modality of screening. Six Guidelines recommended the treatment of high-grade AIN and four guidelines describe a follow-up protocol of patients diagnosed with AIN. There appears to be increasing consensus on the treatment and follow-up of patients despite a poor evidence base. There is still significant discrepancy in guidance on the method to identify patients at risk of ASCC and AIN despite consensus between geographical regions on which patient subgroups are at the highest risk.
Date Issued
2021-09-04
Online Publication Date
2022-01-26T11:25:58Z
Date Acceptance
2021-08-23
ISSN
2038-131X
Publisher
Springer
Start Page
2047
End Page
2058
Journal / Book Title
Updates in Surgery
Volume
73
Issue
6
Copyright Statement
© The Author(s) 2021.
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
License URI
Identifier
https://link.springer.com/article/10.1007%2Fs13304-021-01156-7
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000692488400002&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Subjects
Science & Technology
Life Sciences & Biomedicine
Surgery
Anal squamous cell carcinoma
HIV
Human papillomavirus
Anal intraepithelial neoplasia
Dysplasia
HIV-POSITIVE MEN
HUMAN-PAPILLOMAVIRUS
CANCER
MANAGEMENT
PREVENTION
CARCINOMA
DIAGNOSIS
COLON
HPV
ANOSCOPY
Anal intraepithelial neoplasia
Anal squamous cell carcinoma
Dysplasia
HIV
Human papillomavirus
Anus Neoplasms
Carcinoma in Situ
Carcinoma, Squamous Cell
Consensus
Humans
Mass Screening
Humans
Carcinoma in Situ
Carcinoma, Squamous Cell
Anus Neoplasms
Mass Screening
Consensus
Science & Technology
Life Sciences & Biomedicine
Surgery
Anal squamous cell carcinoma
HIV
Human papillomavirus
Anal intraepithelial neoplasia
Dysplasia
HIV-POSITIVE MEN
HUMAN-PAPILLOMAVIRUS
CANCER
MANAGEMENT
PREVENTION
CARCINOMA
DIAGNOSIS
COLON
HPV
ANOSCOPY
Publication Status
Published
Date Publish Online
2021-09-04