Anal Dysplasia in Patients With Inflammatory Bowel Disease and Healthy Controls

IBD patients attending the Stanford Inflammatory Bowel Disease (IBD) clinic and age-matched
healthy controls are screened for eligibility. Informed consent is obtained for eligible
subjects. An anonymous self-administered questionnaire is administered to assess risk
factors for HPV. For IBD patients, information regarding IBD diagnosis and treatment is
obtained.

An anal pap smear is performed at the time of a clinic visit or at the time of an already
scheduled colonoscopy. Samples are collected and processed at Stanford pathology where a
blinded pathologist reads all specimens. Human Papillomavirus (HPV) DNA testing is performed
on all specimens. All patients with anal squamous intraepithelial lesion (ASIL) are
referred to a colorectal surgeon for further recommendations or treatment, which includes a
high-resolution anoscopy.

Inclusion Criteria:

- All IBD patients followed in the IBD clinic and healthy controls who are greater than
18 years old

Exclusion Criteria:

- History of HPV vaccination

- Pregnancy

- Other immunosuppressed states (i.e. systemic lupus erythematosus, rheumatoid
arthritis, cancer, Human Immunodeficiency Virus (HIV), transplant)

- IBD patients who don't meet immunosuppression/non-immunosuppression criteria

- Inability to obtain informed consent from patient

- Previous diagnosis of ASIL or anal/rectal cancer