[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-353970-105":59,"doc-detail-353970-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","anal-high-grade-squamous-intraepithelial-lesions-identification-classification-and-management","Anal high-grade squamous intraepithelial lesions - identification, classification, and management","","Squamous intraepithelial lesions are premalignant anal conditions with a slowly increasing global incidence, especially in immunosuppressed individuals and men who have sex with men. Chronic human papillomavirus infection drives dysplastic change, with high-risk HPV genotypes such as 16 and 18 responsible for most high-grade precancer and progression to invasive cancer. Current classification relies on dysplasia grade, distinguishing LSIL from HSIL, and supports active screening. High-resolution anoscopy enables visualization and treatment of subtle lesions, with emerging AI expected to improve diagnosis and implementation.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/anal-high-grade-squamous-intraepithelial-lesions-identification-classification-and-management/353970/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/anal-high-grade-squamous-intraepithelial-lesions-identification-classification-and-management/353970.png","ImageObject",300,407,{"name":92,"@type":93},"Kyle","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-09-27","2026-09-22",true,{"@type":102,"interactionType":103,"userInteractionCount":14},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What causes high-grade squamous intraepithelial lesions to develop and progress?","Question",{"text":112,"@type":113},"They are driven by chronic human papillomavirus infection that induces cellular proliferation and dysplastic modification. High-risk HPV genotypes such as HPV 16 and 18 account for most high-grade precancerous lesions and their progression to invasive cancer.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How are anal squamous intraepithelial lesions classified?",{"text":117,"@type":113},"They are classified according to the degree of dysplasia in the anal epithelium. Anal intraepithelial neoplasia I (LSIL) describes low-grade dysplasia capable of spontaneous regression, while anal intraepithelial neoplasia III (HSIL) describes lesions with potential for infiltration and malignant change.",{"name":119,"@type":110,"acceptedAnswer":120},"Why is screening and treatment important for high-risk groups?",{"text":121,"@type":113},"Proactive treatment of HSIL significantly reduces the development of anal cancer. The document states that active screening in high-risk individuals is now established.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},353970,1790471177,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":14,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":44,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144},3985741905716,"https://ap-avatar.wpscdn.com/davatar_994ba38a5ba835b3df7d355c54d3ed8d","BJS, 2026, znag006  \n[https://doi.org/10.1093/bjs/znag006](https://doi.org/10.1093/bjs/znag006)  \nReview Article  \nAnal high-grade squamous intraepithelial lesions: identification, classification, and management  \nEmanuel Cavazzoni1,*, Mariangela Desantis2, Carlo Vivaldi3, Hartmut Schäfer4 and Massimiliano Mistrangelo5  \n1School of Medicine, University of Perugia, Perugia, Italy 2Policlinique Santa Maria, Groupe Kantys, Nice, France 3Faculty of Medicine, University of Cologne, Cologne, Germany 4Faculty of Medicine, University of Cologne, Cologne, Germany  \n5Città Della Salute e Della Scienza, Università Degli Studi di Torino, Torino, Italy  \n*Correspondence to: Emanuel Cavazzoni, University of Perugia School of Medicine, Sezione di Gastroenterologia, Piazzale Gambuli 1, 06132 Perugia, Italy  \n(e-mail: [emanuelcavazzoni@hotmail.com](emanuelcavazzoni@hotmail.com))  \nAbstract  \nSquamous intraepithelial lesions are premalignant conditions for anal cancer, the incidence of which is slowly increasing worldwide. These premalignant lesions are commonly found in high-risk individuals such as those who are immunosuppressed, and men who have sex with men. The development of squamous intraepithelial lesions is driven by chronic human papillomavirus infection that induces cellular proliferation and dysplastic modification in mucosal and cutaneous epithelia. Among a wide family of human papillomavirus strains, high-risk genotypes such as human papillomavirus 16 and 18 are responsible for most high-grade precancerous lesions and their subsequent progression to invasive cancer.  \nHistorically, premalignant lesions have been described by a variety of different classification systems that has changed as our understanding of their pathophysiology has evolved. Precancerous lesions are currently classified based on the degree of dysplasia in the anal epithelium. Anal intraepithelial neoplasia I or low-grade squamous intraepithelial neoplasia (LSIL) describes a low-grade dysplastic lesion capable of spontaneous regression, while anal intraepithelial neoplasia III or highgrade squamous intraepithelial neoplasia (HSIL) describes those lesions with capacity for infiltration and malignant change. The need for active screening in high-risk groups is now established, as proactive treatment of HSIL significantly reduces the development of anal cancer.  \nHigh-resolution anoscopy is a diagnostic modality that allows for the identification and treatment of anal dysplasia, halting its progression to squamous cell carcinoma. Using vital dyes and dedicated instruments offering high magnification and resolution, it is possible to visualize and treat very small and/or flat premalignant lesions that would be invisible on standard diagnostic anoscopy. The evolution of artificial intelligence is set to further enhance its diagnostic ability, and shorten the learning curve for its implementation.  \nIntroduction  \nAlthough considered rare, anal cancer has shown a progressive increase in incidence over recent decades1 , with a frequency of more than two cases per 100 000 people and a 5-year mortality rate close to 30%(Fig. 1)2. The main reason for this is the spread of human papillomavirus (HPV) in the general population, partly due to changes in sexual habits, but also the growing population of immunosuppressed patients (not exclusively those with human immunodeficiency virus (HIV) infection) and their increasing life expectancy.  \nIt is now well known that anal squamous cell carcinoma (ASCC) is preceded by premalignant lesions induced by chronic HPV infection in the anal canal and perianal region. These dysplastic lesions are known as squamous intraepithelial lesions (SILs) and tend to progress to invasive cancer in a highly variable percentage and typically over a long time. The natural history of anal cancer almost entirely mirrors that of cervical cancer, which notoriously takes decades to progress  \nfrom HPV infection to high-grade dysplasia and finally to invasi","cbCaij65egeu3Mop","https://ap.wps.com/l/cbCaij65egeu3Mop","pdf",32516545,"English","# Abstract\n# Introduction\n## Epidemiology of anal cancer and HPV\n## Natural history and prevention\n# High-resolution anoscopy and emerging AI","[{\"question\":\"What causes high-grade squamous intraepithelial lesions to develop and progress?\",\"answer\":\"They are driven by chronic human papillomavirus infection that induces cellular proliferation and dysplastic modification. High-risk HPV genotypes such as HPV 16 and 18 account for most high-grade precancerous lesions and their progression to invasive cancer.\"},{\"question\":\"How are anal squamous intraepithelial lesions classified?\",\"answer\":\"They are classified according to the degree of dysplasia in the anal epithelium. Anal intraepithelial neoplasia I (LSIL) describes low-grade dysplasia capable of spontaneous regression, while anal intraepithelial neoplasia III (HSIL) describes lesions with potential for infiltration and malignant change.\"},{\"question\":\"Why is screening and treatment important for high-risk groups?\",\"answer\":\"Proactive treatment of HSIL significantly reduces the development of anal cancer. The document states that active screening in high-risk individuals is now established.\"}]","Anal high-grade squamous intraepithelial lesions - identification, classification, and management | PDF",1790108248,23]