ART and Screening Can Help to Reduce the Number of Anal Cancer Cases

Investigators from the Swiss HIV Cohort Study found that the number of anal cancer cases would reduce and published their report on that topic in AIDS edition. They concluded that preventative care like screening and taking ART drugs are more effective than screening for cervical cancer among women in the general population.

“This is the first study to predict the incidence of anal cancer in HIV-positive MSM over many years taking into account cART coverage and individual CD4 cell trajectories. Our modeling study predicts substantial reductions in anal cancer incidence in MSM in the next 15 years, even in the absence of screening and without further increases in cART coverage. The model also predicts that the introduction of yearly anal Pap screening or anoscopy screening, or CD4 cell guided anoscopy screening would reduce anal cancer incidence further.” - said the investigators of the study.

Cases of anal cancer among HIV-negative gay men is 5 cases per 100,000 person-years,  as aidsmap report, so anal cancer is more common among HIV-positive gay men. Known risk factors for anal cancer in HIV-positive gay men are persistent infection with high-risk HPV strains, smoking and a low CD4 cell count.

ART increases CD4 cell count and research conducted in North America and the Netherlands suggests its widespread use has already been associated with a plateauing of incidence of anal cancer among gay men with HIV.

Screening for anal cancer can be done in two ways. Cytology uses a PAP smear, where a cell sample is taken and examined under a microscope for pre-cancerous or cancerous changes.

“Clearly, further research on the cost-effectiveness and acceptability of different strategies for anal cancer screening is warranted. In the meantime, increasing cART coverage further in MSM and the HIV-positive population in general remains an important priority in Switzerland and globally.” - said the investigators.