Anal Dysplasia

What is anal dysplasia? 

Anal dysplasia is an abnormal cell change, commonly caused by human papilloma virus (HPV) infections, in the anal canal (last section of your intestines before the poo exits). Anal dysplasia is not cancer. It is categorised into either low grade SIL (LSIL) or high grade SIL (HSIL).  LSIL does not turn into cancer but HSIL is a precancerous condition that can develop into an anal cancer.

Risk factors for anal dysplasia

The factors that increase the risk of anal dysplasia are quite similar to those of anal cancer

  • Human papillomavirus (HPV) virus infection in the genital or anal area

  • HIV infection / AIDS

  • Immunosuppressive medications (medications that suppresses your immune system)

  • Unprotected anal intercourse 

  • Smoking of tobacco 

  • Older ages 

  • Multiple sexual partner 

Symptoms of anal dysplasia

Anal dysplasia often has no associated symptoms until it has advanced to anal cancer. These symptoms when occur may include 

  • Bleeding from the anus

  • A growth in the anus 

  • Anal itch 

  • Mucus discharge from the anus 

  • Pain in the area of the anus 

How is anal dysplasia treated?

A consultation with your GP and subsequent referral to a colorectal surgeon will ensure that your symptoms are appropriately assessed and treated 

Treatment options will be dependent on the extent and the type of dysplasia 

  • Topical 5% Imiquimod (Aldara) or 5% 5FU cream: 2-3 months duration of therapy 

  • Electrocautery: a gentle brush of this instrument over the affected area 

  • Evaluation with acetic acid and targeted excision of lesions +/- wide local flap (sometimes a local flap of normal tissue adjacent to the removed area is used to cover the large defect) 

How is anal dysplasia prevented? 

  • Getting vaccination against HPV 

  • Using a condom 

  • Limiting the number of sex partners 

  • Stop smoking 

Who should be screened for anal dysplasia? 

  • People with HIV 

  • People who have regular anal sex 

  • People with a history of anal warts 

  • People who have had other HPV related cancers 

  • People who are immunosuppressed by certain disease or by medications 

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Anal Fistula/Abscess