Providence Dysplasia Clinic
Preventing anal cancer by diagnosing and treating anal dysplasia
Anal dysplasia is a family of conditions ranging from low-grade lesions, such as warts and early precancers, to high-grade precancerous lesions that have the potential to become anal cancer. Recent reports have shown that an increasing number of people – especially those in high-risk populations – are being diagnosed with high-grade precancerous lesions and anal cancer.
The Human papillomavirus (HPV) is the most common sexually transmitted virus in the United States. Between 50 percent and 75 percent of sexually active men and women get HPV at some point in their lives. HPV is passed from one person to another through genital contact, most often during vaginal and anal sex, although it can be passed through other forms of sexual contact. In 90 percent of cases, the body’s immune system clears the HPV infection naturally within two years. In 10 percent of cases, the HPV infection becomes chronic and can cause precancerous anal dysplasia lesions and cancer. Most people with HPV do not have noticeable symptoms, but that does not mean anal dysplasia has not developed.
Although anal cancer is relatively rare in the United States, occurrence rates are rising in some high-risk groups. By finding anal dysplasia early and providing treatment, we can prevent the development of some cancers.
Who is most at risk?
People at higher risk of developing anal dysplasia include:
• Those with chronically suppressed immune systems, such as those living with HIV or AIDS and those who have received solid organ transplants
• Those who have a history of receptive anal intercourse
• Women with a history of cervical, vaginal or vulvar dysplasia or cancer
• Men who have sex with men
• Those who have a history of HPV infection (including genital or anal warts) or previous anal cancer
• People with chronic anal irritation, growths or lesions that bleed
If you are at increased risk for anal dysplasia, please talk with your primary care provider. The screening for this condition is a simple test, and it can save your life.
At Providence Dysplasia Clinic, our patients receive high quality care in the safest, most efficient way possible. We tailor our services to meet the needs of each patient.
At our clinic, we offer:
• Assessment of the patient’s risk factors and anal health
• Information about HPV and HPV vaccination
• Anal Pap smear screenings
• High-resolution anoscopy (magnified examination of the anal canal) to identify precancerous lesions
• Biopsy of lesions that appear abnormal
• Treatment of precancerous tissue with topical and light therapies
• Patient education and support for anal health
• Follow-up monitoring for those at risk of developing anal cancer
• Prompt treatment of recurrences
• Communication with the patient’s primary care provider
• Collaboration with our multidisciplinary team, giving the patient access to integrative medicine, nutrition counseling, psychosocial support and smoking cessation information
Screening and treatment options
All precancerous anal dysplasia lesions and nearly 90 percent of anal cancers are associated with chronic HPV infections. An anal Pap smear is a simple screening test that allows health care providers to detect precancerous changes caused by HPV. If the Pap smear indicates the presence of dysplasia, further examination is done with high-resolution anoscopy and biopsies.
To prevent dysplasia from progressing to cancer, we use high-resolution anoscopy (magnified examination of the anal canal), to accurately diagnose and biopsy abnormal lesions. This outpatient procedure is performed with state-of-the-art diagnostic equipment. If dysplasia is present, we can use topical therapies and light-based treatments to destroy precancerous lesions.
Office-based procedures, along with high-resolution anoscopy, have been shown to eliminate 80 percent of high-grade precancerous lesions and to reduce to less than one percent the number of lesions that progress into anal cancer.
After treatment, anal dysplasia may occur in new areas and may return to previously treated areas. For that reason, continued monitoring is essential.
For more information, call Providence Dysplasia Clinic at 503-215-1600![]( "Call: 503-215-1600")
or click on our brochure below.
Development of Providence Dysplasia Clinic has been led by Mark Whiteford, M.D., F.A.C.S., F.A.S.C.R.S., director of the Colorectal Cancer Program at Providence Cancer Center. Care for patients at Providence Dysplasia Clinic will be provided by Dr. Whiteford and Michelle Chiu, a certified nurse practitioner trained in high resolution anoscopy through the American Society for Colposcopy and Cervical Pathology. Michelle is member of the Gay and Lesbian Medical Association (GLMA) and an active volunteer at the Cascade AIDS Project and the Sexual Health 4 Men Coalition in Portland.