IANS Advanced HRA Course


Friday November 13th

12:00  Registration

1:00    Opening Remarks – S. Goldstone, M.D.

1:15    HPV Update: epidemiology of HPV in the anus and other sites – what’s new?- J. Palefsky, M.D.

2:05    Pathology for the non-pathologist: new developments in pathology, including biologic markers, and the

   LAST terminology – T. Darragh, M.D.    

2:55    Q & A

3:15    Coffee Break

3:30    Panel on Advanced Issues in Intra-anal HRA:      

1)   The obscured exam: different reasons exams can be technically difficult, tips for visualizing under trying circumstances (Berry)

2)   The discordant exam: cytology, histology or clinical discordant results  (Goldstone)

3)   There’s more than mosaic patterns and punctation: recognizing other lesion characteristics and the distal canal (Jay)              

4:30    Workshop I: Case-based discussions led by faculty

Emphasis on difficult HRA, lesion recognition, distal canal disease, management strategies to include:

                        Cases of discordance and how to manage

                        Hemorrhoids and prolapse

                        Getting to the folds

                        Distal canal lesions           

6:10    Adjourn

6:30    Optional: Meet & Greet the faculty and fellow attendees

Day 2 Saturday November 14th

7:00    Breakfast (provided)

7:30    Faculty available for Q & A

7:45    Dermatology of the Perianus

8:30    Q & A

8:45    Advanced HRA of the perianus: recognizing HSIL and Cancer – N. Jay, RN NP

9:30    Q & A

9:45    Panel on Issues of Perianal HRA

1) Treating perianal disease: different strategies (TBD)

2) Elements of a good perianal work-up (Jay)

3) Under-treated, recurrent disease, or chronic recurrent disease  (Goldstone)

10:45   Coffee Break

11:00   Workshop cases: Dermatology and perianal disease led by faculty

                        Is it HSIL, is it something else, where would you biopsy?

                        This looks bad – how would you treat it

                        Cases of difficult management in anal/vulvar or anal/scrotal disease


12:40   Lunch Break (provided)

1:30     Lecture: Basic science – advanced immunology and virology, what’s new – J. Palefsky, M.D. 

            Q & A 10 minutes

2:35     Proctology: recognition of non-HPV anal disease and management – S. Goldstone, M.D.

            Q & A 10 minutes

3:35     Q & A

3:45     Coffee Break

4:00     Panel: We have identified HSIL, we can do HRA, but now what?

Controversies in Screening, Treatment and Management:

Screening: not ready for primetime (TBD)

Optimal screening and follow up: the role of cytology, DARE, HRA, HPV (Goldstone)

Identification of populations for screening (Palefsky)

5:00    Workshops: screening and follow-up algorithms: potential management strategies following diagnosis and treatment of HSIL         – led by faculty


6:00    Q & A

6:30    Adjourn


Day 3: Sunday November 15th

7:00    Breakfast (provided)

7:30    Faculty available for Q & A

7:45    The art of ‘anus whispering’ - C. Law, M.D.

8:30    Q&A

8:45    Anal Cancer: new strategies for treatment and management – J. Berry, M.D.

9:30    Q&A

9:45    Up Close and Personal: anal cancer survivor’s perspective  - 2 cancer survivors will discuss their experiences

10:30  Q&A

10:45  Coffee break

11:00  Management of the Patient with Anal Cancer:                        

Metastatic and recurrent: what are their options

Taking care of treatment related symptoms: incontinence, bleeding, impotence, inability to have anal sex

                        Post-cancer treatment management (Goldstone)

12:00  Workshops: cancer-related case discussions – led by faculty


                        Post treatment management and HRA findings post-radiation

                        Cancer found subsequent to ablation

                        Recurrent cancer work-up

                        Frank presentation with equivocal biopsy


1:00    Summary and Wrap-Up

1:30    Adjourn

International Anal Neoplasia Society

PO Box 2023
Montgomery Village, Maryland 20886
Fax 301-330-5028
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