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High Resolution Anoscopy After an Abnormal Anal Pap Smear

High Resolution Anoscopy After an Abnormal Anal Pap Smear

Recently, we explored the indications for when an individual needs to seek out an anal pap smear. Those who are at increased risk, or those who are experiencing symptoms, are encouraged to see a physician who is knowledgeable in the area.

When an anal pap smear yields abnormal results, it can be concerning. It is important to keep in mind that while HPV is the cause of 90% of anal cancers, a small percentage of people with HPV will develop precancerous cells, and only a fraction of those individuals will develop anal cancer. Before we discuss the next steps in testing, let’s define the terms you may hear in your doctor’s office.

  1. Anal Dysplasia occurs when the cells inside the anal canal experience abnormal growth. A diagnosis of anal dysplasia requires close monitoring and follow-up evaluation of any new lesions.
  2. HSIL is a High Grade Squamous Intraepithilial Lesion. This is a pre-cancerous change to the skin of the anal canal or perianal area.
  3. LSIL is Low Grade Squamous Intraepithilial Lesion, which is also known as mild dysplasia. While these warts or lesions are not considered pre-cancerous, they can turn to HSIL in time.

Following an abnormal anal pap smear, a High Resolution Anoscopy (HRA) should be performed to examine and evaluate the anal canal. This is a simple procedure that may last about 15 minutes, and you do not need to do any special preparation prior to your visit. During an HRA, a liquid is used to help identify any abnormalities. A long round plastic tube called an anoscope is then inserted into the anal canal; a colposcope, a high-resolution microscope, is used to view the cells. If abnormal cell growth is observed, a biopsy can be taken to test for dysplasia or cancer.

If you or someone you care about has been presented with abnormal results from an anal pap smear, it is important to follow up with a provider who performs HRA. Proper monitoring for abnormal cell growth can prevent future severe problems. At the HPV Center of America, we specialize in caring for patients with this sensitive problem. We help with screening and diagnosis of anal dysplasia, as well as treatment of anal and genital warts, utilizing combination therapy. Let’s begin a conversation today.


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