Screening practices for anal dysplasia with the use of anal cytology and high-resolution anoscopy (HRA) has become a topic of increased interest to colon and rectal surgeons. However, screening continues to be practiced by a minority of clinicians. One major hurdle is how to incorporate anal cytology screening programs into busy colorectal surgical practices. In this article, I highlight my early experience treating anal dysplasia and review my current approach and practice pattern for treating anal dysplasia. I also suggest a few paradigms for implementing screening into various clinical settings, and offer surveillance algorithms for individual patients with anal dysplasia based on risk factors.
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