Health Insights

The University of Cincinnati Cancer Center is leading the charge in the fight against anal cancer by introducing advanced technology to expand access to High Resolution Anoscopy (HRA)—a groundbreaking technology that allows for early detection and treatment of precancerous lesions. UC Health has been at the forefront of offering HRA in the region, and this expansion increases patient access to recommended anal cancer screening.

Performed by Dr. Thompson, an associate professor and expert in colorectal and anal cancer screening, HRA provides unparalleled precision in detecting anal squamous intraepithelial lesions (ASILs) and other abnormalities. The procedure plays a vital role in preventing anal cancer, which has been increasing in incidence, particularly in high-risk populations.

Why Anal Cancer Screening Is More Important Than Ever

Although anal cancer is less common than colorectal cancer, cases have steadily risen, especially in those with:

• A history of human papillomavirus (HPV) infection, particularly high-risk HPV types linked to cancer. 

• HIV, which weakens the immune system and increases susceptibility to anal dysplasia.

• Men who have sex with men (MSM), a group with significantly higher rates of anal neoplasia. 

• Individuals with a history of cervical cancer or abnormal cervical cytology, due to HPV-related risks.

• People with suppressed immune systems, such as organ transplant recipients. 

Unlike standard anoscopy, HRA offers a more detailed examination of the anus and lower rectum, helping detect abnormal cells and dysplasia before they progress into invasive anal carcinoma.

The ANCHOR Study: A Game-Changer in Anal Cancer Prevention

Our decision to introduce HRA technology aligns with the landmark ANCHOR trial, a large-scale study funded by the National Cancer Institute. The research found that treating high-grade anal intraepithelial neoplasia (AIN III)—a precancerous condition—can reduce the risk of anal cancer by 57%. This is particularly significant for HIV-positive patients, a group disproportionately affected by anal squamous cell carcinoma. 

The ANCHOR study was a landmark trial demonstrating that treating high-grade anal intraepithelial neoplasia (AIN III) can significantly reduce anal cancer risk in high-risk patients. HRA plays a key role in identifying these treatable precancerous lesions.

By integrating these findings into our clinical practice, we can provide targeted treatment strategies, ensuring that patients receive care that aligns with the latest scientific evidence.

How High Resolution Anoscopy (HRA) Works

Unlike a routine anal Pap smear or standard anoscopy, HRA is an advanced diagnostic tool that allows specialists to:

• Closely examine suspicious lesions in the anus and lower rectum using a high-powered magnifying scope. 

• Identify abnormal tissue and areas of neoplasia that may require biopsy.

• Apply Lugol’s solution, a special iodine stain, to detect precancerous lesions. 

• Perform a targeted biopsy of any lesions or anal polyps that appear concerning.

If biopsy results confirm high-grade dysplasia, immediate treatment can significantly reduce the risk of progression to anal carcinoma. 

UC Health’s Commitment to Excellence in Cancer Prevention

Thanks to generous donor funding, our clinic is now equipped with the latest HRA examination technology. Dr. Thompson, a board-certified colorectal surgeon with specialized training in HRA interpretation, leads this initiative. This advancement means that more patients can receive timely and effective screenings, particularly those in high-risk groups.

Thanks to generous donor support, we have expanded access to advanced HRA screening, reaching more at high-risk patients who need it most. 

The Connection Between Anal Cancer and Cervical Cancer

There are striking similarities between anal cancer and cervical cancer, both of which are often caused by high-risk HPV types. This has led to parallels in screening and prevention strategies, with HRA serving a similar role in anal cancer prevention as cervical colposcopy does for cervical cancer.

Just as routine Pap smears help detect abnormal cervical cytology, anal cytology and HRA help identify abnormal anal tissue before it becomes cancerous.

Next Steps: Who Should Get an HRA?

f you have any of the following conditions, your healthcare provider may recommend an HRA screening:

✔️ A history of anal warts or HPV-related lesions 
✔️ A previous diagnosis of high-grade anal dysplasia 
✔️ HIV-positive status 
✔️ A history of abnormal anal cytology 
✔️ A weakened immune system

Early detection is key. If suspicious lesions are found, a biopsy can confirm the presence of pre-cancerous or cancerous changes. 

Looking Ahead: Setting a New Standard for Anal Cancer Prevention 

The expansion of HRA services at the University of Cincinnati Cancer Center strengthens our ability to prevent and detect anal cancer early. By offering advanced screening methods, we are improving patient outcomes, identifying precancerous changes sooner, and elevating the standard of care for at-risk populations in our region. 

For more information or to schedule an appointment, visit The University of Cincinnati Cancer Center.