This course was an introduction to High Resolution Anoscopy and anal neoplasia specifically geared toward surgeons. 

Course content

Attendees learned about the incidence of benign, pre-malignant and malignant anal lesions and the required diffuse practice in diagnosis and treatment of these conditions, consequent to human papilloma virus (HPV) infection. Some populations are at a higher risk of HPV infection than anal cancer.

Learning objectives

This course served as an introduction to AIN diagnosis and treatment procedures and upon completion of the course the participants could:

  • Describe the epidemiology and pathology of anal HPV infection, Anal Intraepithelial Neoplasia (AIN), and anal cancer.
  • Identify patients who may benefit from anal cancer screening.
  • Have and understanding of the diagnostic procedures used in the evaluation of AIN and anal cancer including anal cytology, high resolution anoscopy, and anal biopsy.
  • Have an understanding of the appropriate treatment and management options for AIN and anal cancer.
  • Have an understanding of prevention options for AIN and anal cancer.


08:35 – 09.00  Introduction to HPV: Scope of the Problem - L.Trenti

09:00 – 09:30  How to Diagnose AIN: the LAST Criteria, Screening and Diagnostics - A.Albuquerque

09:30 – 10:00  Fundamentals of HRA - C.Ratto 

10:00 – 10:30  HRA Findings of AIN and Biopsy - E.Cavazzoni

10:30 – 11:00  HRA Guided Treatment Options and Management Algorithms - T.Cuming

11:00 – 11:30  Anal Dysplasia Screening in Europe: Special Considerations - M.Nathan

11:30 – 12:00  Panel Discussion and Questions

12:30 – 14:00  Morning rotation (attendees will be separated into three groups)

  • Lesion identification - L.Trenti
  • Hands-on Workshop: HRA Technique - E.Cavazzoni
  • Hands-on Workshop: HRA and Biopsy Technique - C.Ratto

15:00 – 16:30  Afternoon rotation (attendees will be separated into three groups)

  • Hands-on Workshop: HRA and Treatment Techniques - T.Cuming
  • Cases: Where to Biopsy and Where to Treat - A.Albuquerque
  • Cases: When and How to Follow Up - M.Nathan

Course director

Carlo Ratto (Italy)

Carlo Ratto

ESCP Affiliates