The field of Human Papillomavirus (HPV)-related anal cancer is experiencing significant evolution, particularly regarding the early detection and management of precancerous lesions. Increasing incidence rates, especially among high-risk groups, underscore the urgent need for improved diagnostic and therapeutic protocols. Current evidence highlights the risk of progression to anal neoplasia without timely intervention, as demonstrated in landmark studies such as those by Clifford et al. and the Anchor Study. Despite attempts to establish screening and treatment guidelines, challenges remain due to hurdles in patient access to diagnostic resources, specialist care, and the lack of unified care pathways.

Recent advancements have introduced sophisticated digital diagnostic modalities, minimally invasive therapies, and technology-assisted surgical techniques—including artificial intelligence, robotics, and real-time digital diagnostics. These innovations promise improved early detection, surgical precision, and enhanced perioperative care, yet their comparative effectiveness and integration into cohesive multidisciplinary care models remain underexplored. Concomitantly, the viral aetiology of anal cancer and its connection to population-wide interventions such as HPV vaccination demand closer collaboration across dermatology, gynaecology, otolaryngology, and primary care. Essential questions persist regarding systematic surveillance, recurrence monitoring, and optimal structures for achieving patient-centred outcomes.

This Research Topic aims to advance understanding and management strategies for HPV-related precancerous and neoplastic anal lesions through fostering diagnostic-surgical innovation and strengthening interdisciplinary collaboration. The main objectives include investigating novel surgical and technology-driven interventions, evaluating the clinical efficacy of prevention and treatment strategies, and integrating multidisciplinary perspectives on patient care. Particular focuses are the adoption of artificial intelligence and minimally invasive solutions, comparative outcomes between surgical and outpatient approaches, and the impact of multidisciplinary pathways on prognosis, quality of life, and recurrence rates.

To gather further insights into the complexities and potential of the surgical and multidisciplinary management of precancerous lesions and anal cancer, this Research Topic welcomes contributions that explore, but are not limited to, the following themes:

o The role of epidemiology in determining optimal screening intervals;
o Multidisciplinary approaches to diagnosis and treatment of multizonal lesions;
o Diagnostic and therapeutic pathways in resource-limited settings;
o The influence and timing of HPV vaccination;
o Emerging diagnostic pathology tools and novel prognostic biomarkers;
o Surgical and procedural treatment strategies for pre-cancerous and neoplastic lesions;
o Approaches to recurrence prevention and post-treatment surveillance;
o New surgical and oncological strategies for recurrent and metastatic anal cancer;
o Technological advances such as AI, robotics, and digital automation in anal surgery;
o Real-time intraoperative diagnostics, margin assessment, and personalized surgical planning;
o Remote monitoring and digital follow-up strategies for early diagnosis;
o Patient-reported outcomes and quality-of-life assessments post intervention.

This Research Topic welcomes, but is not limited to, original research, systematic reviews, meta-analyses, clinical studies, perspectives, and case series.

Prof. Tamburini reports travel and conference grants from THD S.p.A. and Biolitec.

Dr. Mistrangelo is course director of High Resolution Anoscopy for THD.

Are you interested in contributing a manuscript to this Research Topic?

Precancerous Lesions and HPV-Related Anal Cancer: The Challenge of Multidisciplinary Diagnostic and Treatment Approach