Reducing Stigma and Fighting Cancer: High-Resolution Anoscopy (HRA) for Anal Dysplasia and HPV Screening

While it may be uncomfortable to discuss, colorectal health is too important to overlook. According to the CDC, approximately 42 million Americans are infected with human papillomavirus (HPV), the primary cause of anal cancer. Once detected, anal cancer is highly curable, but, as with many other forms of cancer, survival rates are higher when detected early. At TPMG Center for Colorectal Surgery, Dr. Lisa A. Coleman offers High-Resolution Anoscopy (HRA) diagnostic procedures, which can help evaluate HPV in the lowest part of the gastrointestinal tract and find signs of dysplasia.

What is Anoscopy?

Anoscopy is a procedure used to evaluate the lowest part of the gastrointestinal tract. Using the HRA device, Dr. Coleman can diagnose and treat anal lesions in their precancerous stage before they can cause harm. The device examines the anal canal using magnification to find areas of dysplasia or abnormal cell growth.

What does HPV have to do with anal cancer?

Human papillomavirus (HPV) is a very common sexually transmitted virus that is spread through skin-to-skin contact. With approximately 70-80% of all sexually active individuals likely to have or become infected with HPV, it’s important to understand the complications associated with the virus. Many who become infected with HPV only have a low-risk type with symptoms such as warts on the hands, feet, tongue, or other private areas like the penis, scrotum, or vagina.

In other cases, some individuals contract a high-risk case of HPV that causes abnormal cell growth (dysplasia). Dysplasia is categorized into two groups: low-grade and high-grade dysplasia. Those with high-grade dysplasia have precancerous lesions that could develop into cancer if left unaddressed. High-grade dysplasia can develop in many areas of the body, including the vagina, throat, penis, and anus. Anal dysplasia is often the first sign that an individual is at risk of developing anal cancer.

What can I expect from an HRA procedure?

Dr. Coleman performs the short, minimally invasive HRA procedures in the office. Before your provider recommends an HRA procedure, you will likely have already undergone an anal pap test and a digital anal rectal exam (DARE). These tests look for signs of HPV, anal dysplasia, and anything else abnormal that may indicate precancerous lesions or anal cancer. If deemed necessary, after the results of these preliminary tests, your provider may recommend that you proceed with an HRA procedure or biopsy to render a diagnosis.

The HRA device essentially functions like a surgical microscope, enabling your provider to better visualize abnormal areas and identify, define, and photograph areas of abnormal tissue in the anal canal. In traditional HRA procedures, a colposcope (a large, bulky device originally designed to detect cervical cancer) is used; however, Dr. Coleman utilizes the compact THD^® ProctoStation HRA Module to perform these procedures, an innovative design with cutting-edge technology and features internal light sources and high-definition imaging to render a more accurate evaluation.

The procedure is generally well-tolerated and relatively painless. Before beginning, your provider will perform a digital anal rectal exam (DARE) using numbing gel, which ensures patients remain comfortable throughout the procedure. You may experience some discomfort or irritation. Once the device is inserted and visualizes the anal canal, your provider will begin the evaluation and take any images necessary for analysis.

In some cases, a biopsy (a small sampling of cells) of an abnormal area may be needed to determine the degree of dysplasia. These biopsies are often painless, as the tissue being sampled contains no nerve endings. After the procedure, once all images and biopsy samples have been analyzed, your provider will review the results with you and discuss any findings or next steps for care.

Is an HRA procedure necessary?

The information gathered during an HRA procedure is critical for rendering a diagnosis and determining a plan for treatment. Through this procedure, your provider can identify anal dysplasia and precancerous lesions and develop a treatment plan to prevent anal cancer. One study found that treating dysplasia significantly reduces a person’s risk of developing anal cancer by approximately 57% for those who are living with HPV.

Unfortunately, there is no known cure for HPV. Individuals who experience persistent high-risk HPV require lifelong evaluation and treatment of recurrent or persistent anal dysplasia to reduce their risk of developing anal cancer.

HRA Procedure in Hampton Roads

Utilizing the HRA diagnostic procedure, Dr. Coleman can effectively determine your risk of anal cancer and create an individualized treatment and evaluation plan that meets your needs. Click here to contact the TPMG Center for Colorectal Surgery.