High-resolution anoscopy: Is it necessary in the management of anal epithelial neoplasia

The prevalence of anal cancer has more than doubled in the United States over the past 30 years. Consequently, there is a need to develop effective screening, treatment, and surveillance programs for patients at increased risk for anal cancer. Many of these approaches have been borrowed from cervical cancer due to the shared pathology involving the human papillomavirus and successful screening and surveillance methods developed with the use of high-resolution magnification. However, there is limited evidence to support the use of high-resolution anoscopy for populations at increased risk for anal cancer. In this review, we will examine the literature evaluating the use of high-resolution anoscopy and its role in the screening, surveillance, and treatment of patients at risk for developing anal cancer.