在英国，很少 (12%) 肛门鳞状细胞癌 (aSCC) 在第一阶段 (T1N0M0) 被早期诊断出来。霍默顿肛门生殖器肿瘤服务 (HANS) 是一家高度专业化的三级中心，通过高分辨率肛门镜检查 (HRA) 来诊断和治疗肛门上皮内瘤变 (AIN)，这是癌症的前兆。在某些情况下，aSCC（此处定义为肛管癌和肛周癌距肛缘不超过 5 厘米）是在转诊 AIN 时发现的；在其他情况下，aSCC 可能在接受 AIN 治疗时发生。我们审查了我们专科部门的 aSCC 诊断，以确定 HRA 是否在高风险队列中的 aSCC 早期检测中提供附加价值。对 2016 年 1 月至 2021 年 6 月期间 HANS 的所有原发性 aSCC 诊断进行了横断面分析。审查记录、组织病理学和放射学报告，以根据 TNM 分类（AJCC 第 8 版）定义肛门癌分期。结果与国家统计局公布的国家肛门癌数据（AJCC 第 8 版）进行了比较。HANS 诊断出 53 例 aSCC； 35 例 (66%) 为第 1 阶段（14 例流行，21 例事件），11 例 (21%) 为 2 阶段（9 例流行，2 例事件）和 6 例 (11%) 为 3 阶段（5 例流行，1 例事件）。没有一个是第 4 阶段；由于另一单位的进一步管理，1 例癌症无法分期。相比之下，2013 年至 2017 年间，英国诊断出 5836 例 aSCC；其中，12.0%为第1阶段，22.8%为第2阶段，33.0%为第3阶段，8.46%为第4阶段； 23.8% 未知或无法上演。与国家统计数据相比，HRA 检测到的早期（即 1 期）癌症 (HDC) 的比例存在统计学上的显着差异 (p < 0.001)。我们的结果表明，HRA 计划内的监测和检查可能会导致 aSCC 的检测在早期阶段进行治疗，可以减少发病率并可能降低死亡率。© 作者 2024。由牛津大学出版社代表英国皮肤科医师协会出版。版权所有。如需商业重复使用，请联系 reprints@oup.com 获取转载和转载的翻译权。所有其他权限都可以通过我们网站文章页面上的权限链接通过我们的 RightsLink 服务获得 - 如需了解更多信息，请联系journals.permissions@oup.com。

In the UK, few (12%) anal squamous cell carcinomas (aSCC) are diagnosed early at stage 1 (T1N0M0). The Homerton Anogenital Neoplasia Service (HANS) is a highly specialised tertiary centre where high resolution anoscopy (HRA) is performed to diagnose and treat anal intraepithelial neoplasia (AIN), a precursor to cancer. In some cases, aSCC (here defined as anal canal cancers and perianal cancers up to 5cm from the anal verge) is found on referral for AIN; in others, aSCC may develop while undergoing AIN management. We reviewed aSCC diagnoses at our specialist unit to establish whether HRA offers added value in the early detection of aSCC in a high-risk cohort.A cross-sectional analysis was performed of all primary aSCC diagnoses at HANS between January 2016 and June 2021. Patient records, histopathology and radiology reports were reviewed to define anal cancer stage per TNM classification (AJCC version 8). Results were compared with national anal cancer data published by the Office for National Statistics (AJCC version 8).Fifty-three aSCC diagnoses were made at HANS; 35 (66%) were stage 1 (14 prevalent, 21 incident), 11 (21%) stage 2 (9 prevalent, 2 incident) and 6 (11%) stage 3 (5 prevalent, 1 incident). None were stage 4; 1 cancer was unstageable due to further management at another unit. By comparison, 5836 aSCCs were diagnosed in the UK between 2013-2017; of these, 12.0% were stage 1, 22.8% stage 2, 33.0% stage 3 and 8.46% stage 4; 23.8% were unknown or unstageable. There was a statistically significant difference in the proportion of early (i.e. stage 1) HRA-detected cancers (HDCs) compared with national statistics (p < 0.001).Our results suggest that surveillance and examination within an HRA programme may lead to detection of aSCC at an earlier stage allowing for less morbid treatment and potentially a lower mortality.© The Author(s) 2024. Published by Oxford University Press on behalf of British Association of Dermatologists. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.