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Session: ePoster: Other Neoplasia and Endoscopy 5 (Mon1015)

EP736 - Detecting Anal Interepithelial Neoplasm During Routine Colonoscopy — Can it Be Translated to Routine Practice. Single Institution Experience

Monday, May 12, 2025
10:31 AM – 10:36 AM PT

    ePoster Presenter(s)

  • MA

    Maryam Aleissa, MBBS (she/her/hers)

    colorectal surgery fellow
    Henry Ford providence hospital
    Michigan State University College of Human Medicine
    southfild, Michigan, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • MF

    Molly Flanagan Synowicz, MD

    General Surgery Resident
    Henry Ford Providence Hospital
    southfild, Michigan, United States

    Disclosure information not submitted.

  • VM

    Vijay k. Mittal, MD

    Hepatobiliary surgeon
    Henry Ford Providence Hospital
    southfild, Michigan, United States

    Disclosure information not submitted.

  • ED

    Ernesto R. Drelichman, MD

    Colorectal surgeon
    Henry Ford providence Hospital
    Southfield, Michigan, United States

    Disclosure information not submitted.

    • Senior Author(s)

  • Jasneet S. Bhullar, MD, MS, FACS, FASCRS.

    Clinical Associate Professor of Surgery MSU/CHM, Program Director Colorectal Surgery Fellowship MSU
    Henry Ford Providence Hospital
    Ascension - MSU Colorectal Surgery Fellowship, MI
    Rochester Hills, Michigan, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

All of the relevant financial relationships listed below have been mitigated.
Maryam Aleissa, MBBS: This individual has no financial relationships with ineligible companies.
Jasneet S. Bhullar, MD, MS, FACS, FASCRS.: This individual has no financial relationships with ineligible companies.
Image or Table (Do Not add text here):

Purpose/Background: 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 of ASCC. This study aims to assess the rate of AIN detection during routine colonoscopy and its clinical significance.

Methods/Interventions: 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, after which the specimens were studied by gastrointestinal pathologists. All patients with confirmed AIN were referred to high resolution anoscopy HRA with treatment.

Results/Outcomes: 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/Discussion:

Discussion:
This study demonstrated that the AIN detection rate was low; however, it may provide significant dividends for the detection of AIN during routine practice . Early detection is important particularly for high-grade lesions, given the potential for progressions to ASCC. These findings raise awareness among endoscopists, particularly in high-risk populations, and point to a need for assessment of the immunocompetent patient undergoing routine colonoscopy. Considering the concerns over biopsy-related complications, none were observed, hence justifying its safety.

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.