Anal dysplasia is an entity becoming increasingly recognized as an important health issue that needs to be addressed. It refers to abnormal cellular or tissue changes in the anal canal as a consequence of HPV or human papillomavirus infection, the same virus which causes cervical cancer. Some strains of this virus cause anogenital warts, but other oncogenic (cancer causing) types result in changes leading to invasive cancer of the anal canal. HPV is very common, especially in men and women with a history of anal intercourse. It is especially prevalent in HIV seropositive patients (over 90%), but even up to 60% of HIV-negative men with a history of anal sex have been reported to be infected with HPV. These same groups have much higher rates of anal cancer than the general population. Since HPV, anal dysplasia and even early cancer often cause no symptoms, all patients at risk should be tested.

The diagnostic starting point for evaluation of anal dysplasia is an anal cytology or Pap test. This simple procedure involves inserting a small swab like a Q-Tip into the anal canal which can collect cells that are then examined under the microscope by a Pathologist. This will determine whether the cells are normal or abnormal. All abnormal Pap tests should be evaluated by high resolution anoscopy or HRA (see HRA under Our Services). HRA, including biopsy if indicated, is done in the office. In addition, we offer office based treatment in selected patients who are found to have severe dysplasia or early cancer (also known as AIN3 and CIS respectively).