Virtual Standard HRA Course Program

    Module 1 

    HPV Background (Epidemiology, Pathogenesis and Anatomy)

    Objectives: 

    • Apply knowledge of lower genital HPV infection, including natural history, to the anal canal
    • Describe anal canal and perianal anatomy
    • Define and identify histopathological and cytopathological features of anal squamous intraepithelial lesions and anal cancer

    1.    Introduction to HPV: General Epidemiology - 30 mins

    2.    Epidemiology of Anal Cancer and Squamous Intraepithelial Lesions (SIL) – 30 mins

    3.    Anal Anatomy – 13 mins

    4.    Pathology 1: Anal Squamous Intraepithelial Lesions and Cancer – 30 mins

    5.    Pathology 2: Interpretation of Anal Cytology – 25 mins

      Total time: approximately 2 hours

      Module 2

      Introduction to HRA and Related Procedures

      Objectives:

      • Understand and define terminology related to HRA
      • Interpret the normal features encountered during HRA with respect to the transformation zone and anal/perianal anatomy
      • Learn the steps of performing an HRA exam and related procedures

      1.    HRA Terminology – 26 mins

      2.    HRA: Features of the Normal Anal Transformation Zone – 21 mins

      3.    HRA Procedures/Skills – 45 mins

      4.    Putting it together: HRA Video – 25 mins 

      Total time: approximately 2 hours


        Module 3

        HRA Pattern Recognition

        Objectives:

        • Identify and differentiate Low-grade (L)SIL and High-grade (H)SIL within the anal canal and perianus
        • Recognize features of invasive disease

        1.    HRA: Identification of LSIL – 20 mins

        2.    HRA: Identification of HSIL – 26 mins 

        3.    HRA: Identification of Perianal Lesions – 28 mins

        4.    HRA: Identification of Cancer – 33 mins

        5.    Tips to improving HRA skills – 31 mins 

        Total time: approximately 2.3 hours


        Module 4

        Treatment of ASIL

        Objectives:

        • Summarize current treatment options for Anal SIL including topical, ablative and excisional methods
        • Describe their mode of action, benefits and complications 
        • Requirements for anesthesia associated with different treatment modalities

        1.    Principles of Treatment – 30 mins

        2.    Topical Therapies – 30 mins 

        3.    Ablative Therapies: Technique – 49 mins

        4.    Anesthesia for Procedures – 11 mins

        Total time: approximately 2 hours


        Module 5

        Screening for HPV-associated Lesions

        Objectives: 

        • Summarize the key principles of screening
        • Recognize how current screening criteria are used in anal cancer screening and anal cancer precursor screening 
        • Identify high-risk groups appropriate for screening

        1.    The WHO Screening Criteria – 35 mins

        2.    Screening for prevention of anal cancer: where do we stand today? - 35 mins

        3.    Tools for anal cancer screening – 32 mins

        4.     Screening guidelines – 21 mins 

        Total time: approximately 2 hours


          Module 6

          Management of Anal Cancer

          Objectives:

          • Describe the standard of care for treatment of invasive anal cancer
          • Recognize the indications for and risks of conservative treatment for early anal cancer
          • Understand the management for recurrent anal cancer
          • Define the role of HRA following treatment of anal cancer

          1.    Anal Cancer Treatment - 31 mins 

          2.    HRA following Cancer – 14 mins 

          Total time: approximately 45 mins


            Module 7

            Management and Counseling

            Objectives: 

            • Outline appropriate management for anal SIL including treatment in the operating room, and follow-up post-treatment
            • Understanding the impact of anal neoplasia on patients

            1.    Treatment Triage: Cases – 45 mins

            2.    HRA in the Operating Room: Two Perspectives – 34 mins

            3.    Messaging: Counseling the Patient with HPV-associated Disease – 28 mins

            4.    The Patient’s Perspective – 32 mins

            Total time: approximately 2.3 hours


              Module 8

              Practicalities for Establishing an HRA Practice

              Objectives:

              • Define components of an HRA practice 
              • Recognize practice metrics, practice standards and international guidelines
              • Learn how to Incorporate research prevention into HRA clinical practice 
              • Describe the indications for HPV vaccination

              1.    Essential Equipment for HRA – 21 mins

              2.    Documentation for HRA – 22 mins

              3.    Guidelines for Creating a New HRA Practice – 20 mins

              4.    HRA Practice Metrics – 28 mins

              5.    HPV Vaccination for prevention – 23 min

              Total time: approximately 2 hours


                Module 9

                Anal Neoplasia in Context

                To receive full CMEs please choose a minimum of 3 topics (subjects noted as optional do not count towards CMEs)

                Objectives: 

                • Expand knowledge to that of other specialty areas that overlap with management of lower anogenital tract disorders

                1.    Non-infectious Disease of the Anus and Perianus – 39 mins

                2.    Vulvar Disease – 31 mins

                3.    Sexually Transmitted Infections, Testing and Treatment – 22 mins

                4.    Diseases of the Colon and Rectum – 30 mins

                5.    Dermatologic conditions – 26 mins

                6.    Coding and Billing (US based providers) - Optional – 34 mins

                7.    HRA and Cervical Colposcopy: Differences - Optional – 23 mins

                8. Incorporating research into clinical practice - Optional – 11 mins


                 

                    The International Anal Neoplasia Society

                    P.O. Box 1543
                    Leesburg, Virginia 20177

                    info@iansociety.org

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