{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T20:06:41Z","timestamp":1773950801785,"version":"3.50.1"},"reference-count":18,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T00:00:00Z","timestamp":1742169600000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Routine histopathological evaluation of haemorrhoidectomy specimens is not ubiquitous amongst surgeons as its utility is debatable. This is the first study to assess the detection rate of anal squamous intraepithelial lesions (aSIL) and anal squamous cell carcinoma (aSCC) in low\u2010 and high\u2010risk patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>This 9\u2010year retrospective study assessed electronic medical records of all patients who underwent excisional haemorrhoidectomy within an Australian tertiary referral hospital. Patients with sinister clinical examination findings were excluded from the study. Data collected included patient demographics, pertinent history, relevant risk factors, histopathology reports and digital rectal examination findings. Cost\u2013benefit analysis of routine pathology submission and a city\u2010wide survey of surgeons to ascertain current practices were also undertaken.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The overall prevalence of incidental aSIL and aSCC was 27 (8.1%); 19 patients (5.7%) had low\u2010grade squamous intraepithelial lesions (LSILs), seven (2.1%) had high\u2010grade squamous intraepithelial lesions (HSILs) and one patient (0.3%) had aSCC. More than three out of four were detected in low\u2010risk patients, with most cases being LSIL. Comparing low\u2010risk and high\u2010risk patients, the observed incidental detection rate of aSIL and aSCC was 6.8% (95% CI 4.49\u201310.17) and 23.1% (95% CI 11.03\u201352.05), respectively. Multivariate logistic regression showed a large, significant association between high\u2010risk risk factors and detecting aSIL and aSCC (OR 3.76, 95% CI 1.32\u201310.68, <jats:italic>P<\/jats:italic>\u2009=\u20090.013). A city\u2010wide survey of surgeons demonstrated that 28.6% do not request routine histopathological evaluation and 64.3% thought that the prevalence of sinister incidental pathology in haemorrhoids was 1% or less. The total cost of conducting routine histopathological evaluation per patient was $96.80 AUD ($59.20 EUR, $65.30 USD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Given the non\u2010negligible incidental detection rate of aSIL and aSCC in both low\u2010risk and high\u2010risk patients, coupled with the cost\u2010effectiveness of histopathological examination, this study suggests that routine histopathological examination should not be restricted solely to high\u2010risk patients. Further study of the benefit of surveillance following clinical detection in low\u2010 and high\u2010risk patients is needed.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.70056","type":"journal-article","created":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T07:20:17Z","timestamp":1742196017000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The value of routine histopathological examination after haemorrhoidectomy in patients at low and high risk of anal squamous intraepithelial lesions and cancer"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-6931-2041","authenticated-orcid":false,"given":"Panuwat","family":"Pornkul","sequence":"first","affiliation":[{"name":"Division of Colorectal Surgery, Department of Surgery Townsville University Hospital  Townsville Queensland Australia"},{"name":"College of Medicine and Dentistry James Cook University  Townsville Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guy","family":"Lampe","sequence":"additional","affiliation":[{"name":"Central Pathology Laboratory, Department of Anatomical Pathology Royal Brisbane and Womens Hospital  Herston Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renae","family":"Bertucci","sequence":"additional","affiliation":[{"name":"Division of Colorectal Surgery, Department of Surgery Townsville University Hospital  Townsville Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shehan","family":"Wickramasinghe","sequence":"additional","affiliation":[{"name":"Division of Colorectal Surgery, Department of Surgery Townsville University Hospital  Townsville Queensland Australia"},{"name":"College of Medicine and Dentistry James Cook University  Townsville Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kerenaftali","family":"Klein","sequence":"additional","affiliation":[{"name":"Returned and Services League of Australia  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chrispen","family":"Mushaya","sequence":"additional","affiliation":[{"name":"Division of Colorectal Surgery, Department of Surgery Townsville University Hospital  Townsville Queensland Australia"},{"name":"College of Medicine and Dentistry James Cook University  Townsville Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9085-6755","authenticated-orcid":false,"given":"Shinichiro","family":"Sakata","sequence":"additional","affiliation":[{"name":"Division of Colorectal Surgery, Department of Surgery Townsville University Hospital  Townsville Queensland Australia"},{"name":"College of Medicine and Dentistry James Cook University  Townsville Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,3,17]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2011.01.015"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445\u20102197.2006.03837.x"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiz614"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/dcr.0000000000000058"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1470\u20102045(12)70080\u20103"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/dcr.0000000000001114"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/dcr.0000000000000387"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.15244"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13304\u2010019\u201000699\u20100"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0399\u20108320(04)95044\u20100"},{"key":"e_1_2_12_12_1","unstructured":"Townsville Co.2021 Census Results Division 9 Community Profile. Townsville: Townsville City Council.2021[Cited 2024 Oct 21]. Available from:https:\/\/www.townsville.qld.gov.au\/__data\/assets\/pdf_file\/0010\/9001\/Community\u2010profile\u2010Division\u20109.pdf"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10151\u2010019\u201002133\u20104"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.13709"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2201048"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.4994"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.28431"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350\u2010004\u20106744\u20105"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.20927"}],"container-title":["Colorectal Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.70056","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,9]],"date-time":"2025-06-09T12:09:14Z","timestamp":1749470954000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/codi.70056"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3]]},"references-count":18,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,3]]}},"alternative-id":["10.1111\/codi.70056"],"URL":"https:\/\/doi.org\/10.1111\/codi.70056","archive":["Portico"],"relation":{},"ISSN":["1462-8910","1463-1318"],"issn-type":[{"value":"1462-8910","type":"print"},{"value":"1463-1318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3]]},"assertion":[{"value":"2024-11-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70056"}}