Lee G, et al. - Researchers analyzed patients with anal intraepithelial neoplasia III for their risk of developing anal carcinoma. In addition, they sought for predictors for subsequent malignancy in these patients. Via retrospectively reviewing the Surveillance, Epidemiology, and End Results registry (1973–2014), they identified a total of 2074 patients with anal intraepithelial neoplasia III and followed them for a median time of 4.0 years (interquartile range, 1.8–6.7 y). In the largest published cohort of patients with anal intraepithelial neoplasia III, anal cancer developed within 5 years in ≈10% of patients. Despite a previous diagnosis of anal intraepithelial neoplasia III, diagnosis at stage T2 or higher was made in nearly one-third of anal cancers. A decreased risk of cancer was noted in association with ablative procedures. As per this study, patients with anal intraepithelial neoplasia III show a considerable rate of malignancy, highlighting the necessity for effective therapies and surveillance.