Skip to main content
2024 ASCRS Annual Scientific Meeting Main banner
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Presentation Icons
CME
CME
Invitation/Ticketed Event
Invitation/Ticketed Event
Invited Lectureship
Invited Lectureship
Award Recipient
Award Recipient
Live Streamed Session
Live Streamed Session
Nurses Contact Hours
Nurses Contact Hours
Self-Assessment
Self-Assessment
Back
ViewAttendees 1

Session: ePoster Monitor 6-Other Neoplasia and Endoscopy 2

eP564 - Factors Associated with Clearance of High Grade Dysplasia After High Resolution Anoscopy: A Single Group’s Experience

Monday, June 3, 2024
8:15 AM – 8:20 AM ET, USA
Location: Baltimore Convention Center, Room 318-320

    ePoster Presenter(s)

  • Katherine C. Lee, MD, MS (she/her/hers)

    Colorectal Surgery Fellow
    Mount Sinai Hospital
    Mount Sinai Hospital
    New York, NY, United States

    Disclosure information not submitted.

    • Author(s)

  • LL

    Lung Lau, MD

    Physician
    Nuvance Health Vassar Brothers Medical Center
    New York, New York, United States

    Disclosure information not submitted.

  • Alex L. Huang, MD

    General Surgery Resident
    Icahn School of Medicine at Mount Sinai
    New York, NY, United States

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

  • AY

    Allen T. Yu, MD, PhD

    General Surgery Resident
    Icahn School of Medicine at Mount Sinai
    New York, New York, United States

    Disclosure information not submitted.

  • MA

    Marnie Abeshouse, MD

    Resident
    Mount Sinai Hospital
    New York, New York, United States

    Disclosure information not submitted.

  • Emily Rinebold, MD

    Colorectal Surgery Fellow
    Mount Sinai
    Mount Sinai Hospital
    New York, NY, United States

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

  • AB

    Alexander Bulanov, DO

    Assistant Professor
    Mount Sinai Colorectal Surgery
    New York, New York, United States

    Disclosure information not submitted.

    • Senior Author(s)

  • SK

    Sanghyun A. Kim, MD

    Associate Professor of Surgery
    Mount Sinai
    Norwood, New Jersey, United States

    Disclosure information not submitted.

Purpose/Background: High resolution anoscopy (HRA) and treatment of high-grade intraepithelial lesions (HSIL) reduces the risk for squamous cell carcinoma in patients living with human immunodeficiency virus (HIV). However, little is known about demographic and social predictors of HSIL clearance after adequate treatment with HRA and fulguration. This study describes a single center’s experience with treatment of HSIL and identifies predictors of HSIL clearance after adequate treatment.Methods/Interventions: This retrospective study of a prospectively maintained anal dysplasia database included patients from September 2018 to September 2023 who 1) had biopsy-proven HSIL; 2) underwent office-based HRA with fulguration or operative fulguration; and 3) had at least one follow up visit in the study period. Patients who had a follow up Pap smear or HRA biopsy with results showing benign or low-grade intraepithelial lesion were considered to have HSIL clearance. Patient characteristics included age, gender, race/ethnicity, primary language, insurance status, HIV status, and history of anal surgery. Logistic regression was performed to identify factors associated with HSIL clearance using Python and STATA.Results/Outcomes: Among 1,002 unique patients in the database, 605 patients had a history of HRA or operative biopsy for anal dysplasia, and 132 met study criteria. Overall, 76 (61.8%) patients had clearance of HSIL (Table). After multivariable analysis smoking status was the only independent factor associated with HSIL clearance (Odds Ratio [95% Confidence Interval]: 2.38 [1.02-5.5]). Medicaid patients were noted to have higher rates of HSIL clearance compared to commercially insured patients, although this trend was not statistically significant (2.21 [0.96-5.07]). Among patients with clearance of HSIL, more were non-smokers (43 vs. 33 non-smokers), median time to clearance was 329 days (interquartile range, IQR: 238-480) and median number of visits to clearance was 1 visit (IQR 1-4).Conclusion/

Discussion: Patients with Medicaid insurance exhibited a trend toward HSIL clearance, suggesting that this vulnerable patient population achieves good outcomes with adequate access to anal dysplasia care and treatment. The association between smoking status and HSIL clearance in this study is contrary to what is expected given that smoking as a known risk factor for anal dysplasia. This finding may be related to smoking status changes due to smoking cessation counseling provided after HSIL diagnosis. This study is limited by sample size and further data collection is needed to further examine social and demographic factors associated with HSIL clearance after adequate treatment.Table. Factors Associated with Clearance of High Grade Intraepithelial Lesion after High Resolution Anoscopy