Survey on Anal/peri-anal Intraepithelial Neoplasia (AIN) in Europe

Dear Doctor,

We are writing to you as a colposcopist/gynaecologist/gynaecological oncologist currently providing a care for lower genital organs neoplasia in an European country.
Routine screening of women with the provision of treatment for cervical precancer helps in the prevention of cervical cancer. However, this is not the case for the prevention of other anogenital cancers in women and men caused by the high-risk HPV infection.
Referral for examination of extra-cervical anogenital sites or screening for all anogenital neoplasia is not universally recommended, upon detection of neoplasia on one site. There are very few national centers in Europe that provide excellent care and act as referral centers in their countries for HPV-related anogenital neoplasia in its full spectrum. Anogenital HPV-related neoplasia care is supplied by several different specialists in the absence of national or regional guidelines for some precancers and this care is variable between countries.
As a result, the European Society for Gynecologic Oncology (ESGO) and European Federation for Colposcopy (EFC) have decided to conduct a survey on anal intraepithelial neoplasia (AIN) in Europe.
The aim of the survey is to:
  • evaluate knowledge, attitudes, and current practice on managing anal intraepithelial neoplasia across European countries
  • identify any future needs
We are interested in your own experiences and practice. High rates of response across Europe will help us understand the current provision of healthcare services, gaps in the provision of care, and future needs in order to design optimal healthcare for women with AIN.
We appreciate you taking the time to complete this survey and providing your feedback to help us support colleagues in managing these difficult conditions.
1.Please state your speciality:
2.If other, please specify:
3.In which country do you work?
4.Type of the service you are working in:
5.Do you perform colposcopy?
6.Who can perform colposcopy in your country?
7.Does nationally approved training in colposcopy exist in your country?
8.Do you have specialized colposcopy clinics in your country?
9.Do you treat cervical and vulvo/vaginal neoplasia?
10.Which groups listed below do you consider to be a high risk groups for AIN?
11.If other, please specify:
12.Do you think that women with high grade intraepithelial neoplasia (HSIL) or cancer of the lower genital organs (cervix/vulva/vagina) are at increased risk for developing AIN?
13.If Yes, how much do you think the risk is increased?
14.In your opinion, which of the listed is the primary screening method for AIN?
15.Which gynecological patients do you refer to high resolution anoscopy (HRA)?
16.If other, please specify:
17.Do you perform HRA yourself?
18.Have you had an organized training in HRA?
19.Are you satisfied with the training you have had in HRA?
20.Do you think that HRA should become a part of gynecologic practice for those who are interested in managing AIN?
21.Are you interested in education for HRA?
22.Is a combined service for AIN patients (colposcopy, lower GI & /or sexual health) provided in your hospital?
23.Who is managing patients with AIN in the hospital you work?
24.If other, please specify:
25.Do you feel that AIN should be managed as an integrated service between colposcopist, lower GI surgeons, dermatologists and experts in sexually transmitted diseases?
26.Do you check the HPV vaccination status of your patients?
27.Are you offering the HPV vaccine for any patient diagnosed with AIN?
28.Are you informing the sexual partners of CIN patients to be examined for lower genital disease including AIN?