Diagnosis and treatment of anal condyloma and anal intraepithelial neoplasia - a need for clinical guidelines: P161

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Aim:The frequency of anal condyloma and anal intraepithelial neoplasia (AIN) is increasing. There are no clinical guidelines for the management of these patients.Method:We analysed risk factors for and outcomes of patients treated for anal condyloma within a colorectal unit. Patients with diagnosis of anal condyloma were included in the Colorectalprospective database from 1994-2010. Risk factors for the development of anal condylomas, dysplasia and the results of treatment were analyzed.Results:Thirty-six patients (27 male, 9 female) with a mean age of 36.5 (± 11.96) years and a mean follow-up of 20.41 (± 14.8) months were included. Twenty-eight (58.3%) were HIV positive and six (16.7%)practiced anal intercourse. Seven females (77.7%) had associated human papilloma HPV gynaecological lesions. Sixteen (44.4%) werepreviously treated by dermatologists. The most frequent operation was excision or fulguration in 26 (72%). The histological findings were: anal condyloma in 22 (61.1%), AIN-I in 2 (5.6%), AIN-II in 4 (11.1%), AIN-III in 7 (19.4%) and invasive carcinoma in one (2.8%). HPV16 genotype was analysed in only five patients (13.9%). Seven (19.4%) recurred. Variables such as HIV status, anal intercourse,previous treatments and associated lesions showed no significant risk for the development of dysplasia (P > 0.05).Conclusion:Currentpractice for condyloma is variable and a considerable % develop AIN-III/carcinoma. There is a need for the development ofprotocols for screening, diagnosis and treatment of these patients.

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