Anal Neoplasia in Homosexual and Bisexual Men

Anal neoplasia is a sexually transmitted disease seen with increasing frequency in anoreceptive homosexual and bisexual men. It bears a striking embryologic, histopathologic, and epidemiologic resemblance to another venereal pathology, cervical neoplasia in women. Although very similar, there is a significant difference between these two preventable processes. The incidence of cervical cancer has decreased, largely due to cancer screening programs; i.e., annual pelvic examination with Papanicolaou smear. To date, no ongoing screening program is in place for the early detection of anal neoplasia in this high-risk male population, accounting for the increasing incidence in anal carcinoma being seen. The following case report best illustrates how the lack of such a routine screening program can impact on a high-risk population; a population that is already besieged with the devastating effects of HIV infection. How such a screening program could be easily implemented is discussed.