Detecting anal interepithelial neoplasm during routine colonoscopy: Can it be translated to routine practice? Single institution experience

Document Type

Conference Proceeding

Publication Date

8-30-2025

Publication Title

Colorectal Dis

Abstract

Aim: Human papillomavirus HPV is a major risk factor for anal squamous cell cancers ASCC, with anal intraepithelial neoplasia as a precursor lesion. The detection of AIN in the setting of routine colonoscopy is not well described despite the potential for early identification. This study aims to assess the rate of AIN detection during routine colonoscopy. Methods: This is a retrospective study performed at a single community-based hospital in Michigan, USA. A consecutive series of 2,000 colonoscopies carried out between January 2021 and December 2023 were retrospectively reviewed. All patients underwent screening colonoscopies wherein the anorectum and transition zones were inspected for AIN lesions with a narrow band imaging, during retroflextion . Biopsies were carried out when suspected abnormalities were found. All patients with confirmed AIN were referred to high resolution anoscopy HRA with treatment. Results: Of the 2,000 patients, 53% were female and 47% male. AIN was identified in 1% of the patients (n = 19) at the time of retroflextion. The median age of AIN patients was 49 years, with 56% males. Of note, 69% (n = 11) were immunocompetent. Of these patients who were referred to HRA, 36% (n = 7) pathology reviled high-grade AIN. Conclusion: Routine colonoscopy with retroflexion using a narrow band imaging offers a good opportunity for AIN detection, even in immunocompetent patients. The possibility of detection of AIN may lead to ASSC prevention. It worth incorporating AIN screening during routine colonoscopy into daily practice as well as in teaching fellow and residents to how identifying these lesions.

Volume

27

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