Purpose
High resolution anoscopy (HRA) is a specialized procedure used to detect abnormal cell changes in the anal canal and surrounding skin. Similar to cervical colposcopy, HRA allows clinicians to magnify and assess suspicious areas and perform directed biopsies. It is particularly important for patients at increased risk of anal cancer, such as those with HIV, a history of receptive anal intercourse, or previous abnormal anal Pap tests.
Indications
- Abnormal anal cytology (Pap smear) results.
- History of HPV‑related genital or cervical dysplasia.
- HIV infection or other immunosuppressed states.
- Persistent anal symptoms such as bleeding, pain, or itching.
What Happens During HRA?
HRA is typically performed in the office. The anal canal is gently examined with a lubricated anoscope. A vinegar (acetic acid) solution may be applied to highlight abnormal cells. A high‑resolution magnifying device allows the provider to identify and biopsy suspicious areas for pathology analysis. The procedure is generally well tolerated.
Treatment
- If abnormal cells (anal intraepithelial neoplasia) are found, treatment options may include topical medications.
- Ablative therapy using heat or chemical agents may be performed to destroy abnormal tissue.
- Excision of lesions may be necessary for more extensive or high‑grade changes.
- Ongoing surveillance with repeat anoscopy and Pap testing is essential to prevent progression to anal cancer.
Our practice offers HRA and works closely with colorectal surgeons and oncologists to provide comprehensive anal cancer screening and prevention.