High-resolution anoscopy: Procedure and findings

High-resolution anoscopy (HRA) using a colposcope or operating microscope with 5% acetic acid and Lugol׳s solutions was developed to identify abnormal epithelial changes such as high-grade squamous intraepithelial lesions (HSIL) and other lesions associated with human papillomavirus (HPV). It is hypothesized that targeted treatment of HSIL will prevent progression to cancer. HRA has become more accepted in clinical practice especially for populations considered at risk for anal cancer including those who are immunocompromised and men who have sex (MSM). While data from prospective clinical trials designed to determine the effectiveness of HRA in preventing cancer are still pending, the procedure is now available in 200 clinics worldwide. This article describes the procedure and identification of lesions for potential treatment.