Abstract
[Truncated] Genital warts have been increasing in incidence over the last few decades to being the
most common infection seen in clinics treating sexually transmissible infections prior
to the advent of human papillomavirus quadrivalent vaccination. They have been
thought to be a cosmetic and nuisance problem and only caused by low-risk genotypes
of human papillomavirus. Research has demonstrated that warts are often mixed
infections with both low and high-risk human papillomavirus infection present, and
they are associated with intraepithelial neoplasia, and malignancy. Over the time this
thesis has been written, the importance of anal cancer as an emerging entity has risen,
particularly because even though it is a rare disease, there are increasing disease rates
in both men and women, and it is considered to be in epidemic proportions in some
sub populations (HIV-positive men and women, and HIV-negative men). In addition,
ways of identifying anal cancer precursors have developed and include anal cytology
and anal cytology screening for anal cancer precursors, and a highly specialised clinical
skill called ‘high resolution anoscopy’ to recognise and histologically confirm the
presence of anal precancer. In addition to my surgical skill of scissor excision of
anogenital warts I have become proficient in high resolution anoscopy and
consequently have been able to research the use of this skill along with cytology and
histopathology to identify anal cancer precursor lesions in high-risk individuals. The
HPV vaccines developed commercially to date are designed for HPV naive individuals,
and hence for those with persistent HPV infection there is a need for a therapeutic
vaccine or treatment.
most common infection seen in clinics treating sexually transmissible infections prior
to the advent of human papillomavirus quadrivalent vaccination. They have been
thought to be a cosmetic and nuisance problem and only caused by low-risk genotypes
of human papillomavirus. Research has demonstrated that warts are often mixed
infections with both low and high-risk human papillomavirus infection present, and
they are associated with intraepithelial neoplasia, and malignancy. Over the time this
thesis has been written, the importance of anal cancer as an emerging entity has risen,
particularly because even though it is a rare disease, there are increasing disease rates
in both men and women, and it is considered to be in epidemic proportions in some
sub populations (HIV-positive men and women, and HIV-negative men). In addition,
ways of identifying anal cancer precursors have developed and include anal cytology
and anal cytology screening for anal cancer precursors, and a highly specialised clinical
skill called ‘high resolution anoscopy’ to recognise and histologically confirm the
presence of anal precancer. In addition to my surgical skill of scissor excision of
anogenital warts I have become proficient in high resolution anoscopy and
consequently have been able to research the use of this skill along with cytology and
histopathology to identify anal cancer precursor lesions in high-risk individuals. The
HPV vaccines developed commercially to date are designed for HPV naive individuals,
and hence for those with persistent HPV infection there is a need for a therapeutic
vaccine or treatment.
| Original language | English |
|---|---|
| Qualification | Doctor of Philosophy |
| Publication status | Unpublished - 2012 |
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