Evidence for Anal Dysplasia Treatment

Anal dysplasia, primarily caused by high-risk human papillomavirus (HPV) infection, presents as a precursor to anal cancer (AC), especially among high-risk populations such as human immunodeficiency virus (HIV)-positive individuals. This review evaluates evidence for the treatment of anal intraepithelial neoplasia, focusing on recent advancements in the context of the Anal Cancer/HSIL Outcomes Research Study (ANCHOR) trial which demonstrates that active treatment of high-grade squamous intraepithelial lesions markedly reduced progression to AC. This affirms the value of proactive treatment strategies over passive monitoring. Furthermore, we will discuss various treatment modalities, including topical agents, electrocautery, and HPV vaccination, and their efficacy and limitations. This review underscores the necessity of integrating screening and targeted interventions, particularly for high-risk groups, to reduce AC incidence. Future research should aim to validate these findings across broader demographic groups, refining public health policies and clinical guidelines to include effective screening and treatment protocols.