LAUSR

Severe acute respiratory syndrome caused by coronavirus 2 (SARS-CoV-2) was first identified in Wuhan, China, in December 2019. Since then the World Health Organization declared the outbreak to be a Public Health Emergency of International Concern on 30 January 2020, and then recognized it as a pandemic on 11 March 2020. Consequent to COVID-19 pandemic, all International and National Societies published countless guidelines about the management of patients affected by COVID-19. In spite of this IANS proposed its guidelines for the use of HRA in anal cancer and its precursors. Considering the costs to deal with COVID-19, the deficiency of healthcare professionals and the lack of worldwide evidence consensus on HRA, this examination cannot be considered mandatory during the COVID-19 pandemic. DARE with biopsy of suspicious palpable lesions in symptomatic patients could be considered enough during this period. Probably a latency of 6-12 months is reasonable for these patients without affecting the natural history of AIN. In conclusion, the current Covid-19 pandemic has been the most discussed topic in the media and scientific journals. However a deluge of scientific publications results in worldwide uncertainty. Guidelines on this topic should only be based on validated studies which support an Evidence Based Medicine approach. In our opinion this is not the case for HRA.