Perianal Bowen's disease then and now: Evolution of the treatment for anal high-grade intraepithelial neoplasia

Amy L. Halverson*

*Corresponding author for this work

Research output: Contribution to journalArticle

1 Scopus citations


Anal Bowen's disease is squamous cell carcinoma in situ occurring in the anal canal or perianal skin and was a rare finding before the human immunodeficiency virus epidemic. Bowen's disease is synonymous with high-grade intraepithelial neoplasia. The pathophysiology and natural history of anal Bowen's disease are analogous to cervical dysplasia. The risk for anal dysplasia is increased in individuals with human papilloma virus infection. Clinical evidence suggests that low-grade anal intraepithelial dysplasia and squamous cell carcinoma in situ are precursors to invasive squamous cell carcinoma. The treatment of Bowen's disease has shifted away from aggressive wide local excision. Current strategies for management of anal dysplasia include surveillance in high-risk individuals with targeted biopsies and destruction of discrete lesions.

Original languageEnglish (US)
Pages (from-to)213-217
Number of pages5
JournalSeminars in Colon and Rectal Surgery
Issue number4
Publication statusPublished - Dec 2003


ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

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