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Article Dans Une Revue (Article De Synthèse) Techniques in Coloproctology Année : 2024

Screening for precancerous anal lesions linked to human papillomaviruses: French recommendations for clinical practice

1 hpsj - Groupe Hospitalier Paris Saint-Joseph
2 Groupe Hospitalier Diaconesses Croix Saint-Simon
3 AP-HP - Hôpital Bichat - Claude Bernard [Paris]
4 Clinique Blomet
5 Unité de Coloproctologie Hopital Bagatelle Talence.
6 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
7 CHRU Tours - Centre Hospitalier Régional Universitaire de Tours
8 Clinique La Croix du Sud
9 Site Tarnier (hôpital Cochin) - APHP
10 IAME (UMR_S_1137 / U1137) - Infection, Anti-microbiens, Modélisation, Evolution
11 CIRC - IARC - Centre International de Recherche contre le Cancer - International Agency for Research on Cancer
12 Hôpital Beaujon [AP-HP]
13 CerbaPath, 16 bis rue Odessa 75014 Paris, France
14 AP-HP - Hopital Saint-Louis [AP-HP]
15 UPCité - Université Paris Cité
16 Clinique Médicale Beausoleil
17 CHU Clermont-Ferrand
18 3IHP - Infection Inflammation et Interaction Hôtes Pathogènes [CHU Clermont-Ferrand]
19 CHRU Besançon - Centre Hospitalier Régional Universitaire de Besançon
20 AMU - Aix Marseille Université
21 TIMONE - Hôpital de la Timone [CHU - APHM]
22 IHU Marseille - Institut Hospitalier Universitaire Méditerranée Infection
23 Hôpital Nord [CHU - APHM]
24 CH Béthune Beuvry - Centre Hospitalier de Béthune Beuvry
25 CHRU Brest - Centre Hospitalier Régional Universitaire de Brest
26 FunGeST - Génomique fonctionnelle des tumeurs solides = Functional Genomics of Solid Tumors [CRC]
27 HEGP - Hôpital Européen Georges Pompidou [APHP]
28 CEF2P / CARCINO - Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (UR 3181)
29 LabEx LipSTIC - Laboratoire d'Excellence : Lipoprotéines et Santé : prévention et Traitement des maladies Inflammatoires et du Cancer
30 UB - Université de Bourgogne
31 Hôpitaux Sud - Hôpital Sainte-Marguerite [CHU - APHM]
L. Spindler

Résumé

In France, about 2000 new cases of anal cancer are diagnosed annually. Squamous cell carcinoma is the most common histological type, mostly occurring secondary to persistent HPV16 infection. Invasive cancer is preceded by precancerous lesions. In addition to patients with a personal history of precancerous lesions and anal cancer, three groups are at very high risk of anal cancer: (i) men who have sex with men and are living with HIV, (ii) women with a history of high-grade squamous intraepithelial lesions (HSILs) or vulvar HPV cancer, and (iii) women who received a solid organ transplant more than 10 years ago. The purpose of screening is to detect HSILs so that they can be treated, thereby reducing the risk of progression to cancer. All patients with symptoms should undergo a proctological examination including standard anoscopy. For asymptomatic patients at risk, an initial HPV16 test makes it possible to target patients at risk of HSILs likely to progress to cancer. Anal cytology is a sensitive test for HSIL detection. Its sensitivity is greater than 80% and exceeds that of proctological examination with standard anoscopy. It is indicated in the event of a positive HPV16 test. In the presence of cytological abnormalities and/or lesions and a suspicion of dysplasia on clinical examination, high-resolution anoscopy is indicated. Performance is superior to that of proctological examination with standard anoscopy. However, this technique is not widely available, which limits its use. If high-resolution anoscopy is not possible, screening by a standard proctological examination is an alternative. There is a need to develop high-resolution anoscopy and triage tests and to evaluate screening strategies.

Dates et versions

hal-04599417 , version 1 (03-06-2024)

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L. Spindler, I. Etienney, L. Abramowitz, V. de Parades, F. Pigot, et al.. Screening for precancerous anal lesions linked to human papillomaviruses: French recommendations for clinical practice. Techniques in Coloproctology, 2024, 28 (1), pp.23. ⟨10.1007/s10151-023-02899-8⟩. ⟨hal-04599417⟩
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