Results of the Application of the Cuban Consensus for Anal Cancer Prevention

Abstract

Introduction: The increase of anal cancer in high-risk populations leads to the implementation of protocols to perform early diagnosis and follow-up of anal intraepithelial neoplasia.

Objective: To evaluate the results of the application of the national consensus for anal cancer prevention in Cuba.

Methods: A prospective longitudinal study was conducted with 43 patients at high risk of intraepithelial anal neoplasia cared for in the coloproctology consultation at Comandante Manuel Fajardo Clinical Surgical University Hospital, from 2018 to 2019. They were evaluated at the time of diagnosis and at six months. Anal cytology studies (normal, low- and high-degree lesions, and atypical epidermoid cells of uncertain significance), anorectal digital examination and high resolution anoscopy (normal, types I-II and III) were performed.

Results: 53.5 % of the results were normal. In abnormal anal cytology findings, low-degree lesion had the highest percentage (50 %). Anal intraepithelial neoplasia type I was the most frequent (52.9 %). Of the patients followed up at six months, the majority had abnormal anal cytology results (55.6 %); 70 % had low-degree lesions. The anorectal digital examination was normal in all cases. The predominant risk factors were anal penetrative sex and male-to-male sex, including that all had had human papillomavirus.

Conclusions: The protocol allowed the identification of primarily low-degree lesions. Risk factors influence the appearance of this neoplasm.