Prevalence of Anal Intraepithelial Lesions in Patients with Inflammatory Bowel Disease

• Main Authors: Mariane Christina Savio, Rosimeri Kuhl Svoboda Baldin, Norton Luiz Nóbrega, Guilherme Mattioli Nicollelli, Antonio Sérgio Brenner, Pollyanna Borges da Rocha, Marssoni Deconto Rossoni, Maria Cristina Sartor, Antonio Baldin Junior
• Format: Article
• Language: English
• Published: Thieme Revinter Publicações Ltda. 2021-09-01
• Series: Journal of Coloproctology
• Subjects: inflammatory bowel disease (ibd); anal cancer; anal intraepithelial neoplasia; human papillomavirus (hpv); crohn's disease; ulcerative colitis
• Online Access: http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1730425
• ISSN: 2237-9363; 2317-6423

Introduction Anal intraepithelial neoplasia (AIN) is a premalignant lesion of the anal canal associated with HPV, with a higher prevalence in immunosuppressed individuals. Patients with inflammatory bowel disease (IBD) are at potential risk for their development, due to the use of immunosuppressants and certain characteristics of the disease. Method This is a prospective, cross-sectional, and interventional study that included 53 patients with IBD treated at a tertiary outpatient clinic, who underwent anal smear for cytology in order to assess the prevalence of AIN and associated risk factors. Results Forty-eight samples were negative for dysplasia and 2 were positive (4%). Both positive samples occurred in women, with Crohn's disease (CD), who were immunosuppressed and had a history of receptive anal intercourse. Discussion The prevalence of anal dysplasia in IBD patients in this study is similar to that described in low-risk populations. Literature data are scarce and conflicting and there is no evidence to recommend screening with routine anal cytology in patients with IBD. Female gender, history of receptive anal intercourse, immunosuppression and CD seem to be risk factors.