TITLE

Treatment of high-grade anal dysplasia in high-risk patients: outcome at an urban community health centre

AUTHOR(S)
Assoumou, S. A.; Panther, L. A.; Mayer, K. H.
PUB. DATE
February 2013
SOURCE
International Journal of STD & AIDS;Feb2013, Vol. 24 Issue 2, p134
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Human immunodeficiency (HIV)-infected patients and men who have sex with men (MSM) have a higher rate of high-grade anal intraepithelial neoplasia (HGAIN), a likely precursor to anal cancer. This retrospective study describes the outcome of treating MSM with incident biopsy-proven HGAIN in an urban community health setting with access to outpatient ablation or operative treatment. The main outcome was freedom from HGAIN at follow-up. One hundred and fifty-three met inclusion criteria; 86 (56%) were HIV-infected. Eighty (52%) received outpatient ablation, 49 (61 %) had a follow-up within nine months. Among those, 26 (53%) were free of high-grade disease, 19 (39%) had high-grade disease; and 4 (8%) had unknown grading. In a logistic regression model, a lower extent of anal disease (1 quadrant versus 2, 3 or 4 quadrants) at the time of treatment was significantly associated with a lower probability of high-grade disease (P value 0.04). HGAIN could be managed in a community health setting; however, systems are needed to ensure follow-up care.
ACCESSION #
87591155

 

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