Background: Anal cancer (AC) can cause symptoms such as anal bleeding, pain or lumps. While high-grade squamous intraepithelial lesions (HSIL) are the precursors of AC, scarce information exists regarding its association with anal symptomatology. This study aims to assess anal symptoms and their association with anal squamous intraepithelial lesions (SIL) and HSIL in a Hispanic high-risk population, as well as predictors of anal symptoms. Methods: Data from the baseline visit of patients attending the Anal Neoplasia Clinic of the University of Puerto Rico Comprehensive Cancer Center (September 2016-December 2023) was analyzed. AC screening was performed and the presence of seven self-reported anal symptoms were assessed at the clinical visit. Logistic regression analyses were performed to evaluate the association of anal symptoms with HSIL by HIV status, as well as predictors of anal symptoms. Results: From 872 patients, 69.0% were people living with HIV (PLWH). HSIL prevalence was 41.7%. Prevalence of self-reported anal symptoms was 19.5%; most common symptoms were bleeding (6.6%), pain or discomfort (5.3%) and lump (4.2%). On multivariable adjusted analysis, HSIL was not associated with having anal symptoms. However, current smoking (OR:1.12, 95% CI:1.04-1.20), having hemorrhoids (OR: 1.10, 95% CI: 1.03-1.16) and anal warts (OR: 1.16 (1.18, 95% CI: 1.08-1.24) were associated with higher odds of anal symptoms. Conclusion: Our results suggest that anal symptoms are not good predictors for HSIL, and that smokers and those with benign anal conditions have increased anal symptomatology. These results highlight the importance of systematic AC screening for prevention and early detection.
Tírado-Gómez et al. (Mon,) studied this question.