Screening Patients at High Risk

Abstract

Comments on an article The differential diagnosis and interdisciplinary treatment of anal carcinoma by D. Raptis et al. (2015). Raptis et al. correctly reported that the incidence of anal cancer rises in HIV positive patients. The increased incidence in patients who are medically immunocompromized is not mentioned in the text in addition to other risk factors. The authors write: 'There are no international, globally accepted, guidelines for screening in high-risk groups.' In September 2013 the Association of the Scientific Medical Societies in Germany (AWMF) published a 'German-Austrian' guideline in which screening in this high-risk group was described. In our opinion, this guideline is the only German-language guideline that deals with human papillomaviruses (HPV), anal dysplasias, and anal carcinomas. One is not aware of any general German guideline for anal cancers. With regard to surgical treatment, Raptis et al. reported that only T1 cancers of the anal margin should be excised. Raptis et al. reported that during follow-up care, incision biopsy is not permitted if relapse is suspected, 'as the risk of incontinence or severely delayed wound healing is extremely high.' In suspected superficial local recurrence, small superficial incision biopsy is possible without damaging the anal sphincter. (PsycINFO Database Record (c) 2017 APA, all rights reserved)