International Anal Neoplasia Society's consensus guidelines for anal cancer screening

Elizabeth A Stier¹, Megan A Clarke², Ashish A Deshmukh^{3

4}, Nicolas Wentzensen², Yuxin Liu⁵, I Mary Poynten⁶, Eugenio Nelson Cavallari⁷, Valeria Fink⁸, Luis F Barroso⁹, Gary M Clifford¹⁰, Tamzin Cuming¹¹, Stephen E Goldstone¹², Richard J Hillman^{6

13}, Isabela Rosa-Cunha¹⁴, Luciana La Rosa^{15

16}, Joel M Palefsky¹⁷, Rosalyn Plotzker¹⁸, Jennifer M Roberts¹⁹, Naomi Jay¹⁷

Affiliations

¹ Department of Obstetrics and Gynecology, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA.
² Division of Cancer Epidemiology & Genetics, National Cancer Institute, Rockville, Maryland, USA.
³ Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina, USA.
⁴ Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina, USA.
⁵ Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
⁶ The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.
⁷ Department of Public Health and Infectious Diseases, Policlinico Umberto I hospital-"Sapienza" University of Rome, Rome, Italy.
⁸ Department of Research, Fundación Huésped, Buenos Aires, Argentina.
⁹ Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
¹⁰ International Agency for Research on Cancer, Lyon, France.
¹¹ Department of Colorectal Surgery, Homerton University Hospital NHS Foundation Trust, London, UK.
¹² Icahn School of Medicine at Mount Sinai, New York, New York, USA.
¹³ St Vincent's Hospital, Sydney, New South Wales, Australia.
¹⁴ Department of Medicine/Division of Infectious Diseases, University of Miami, Miami, Florida, USA.
¹⁵ Centro Privado de Cirugía y Coloproctología, Buenos Aires, Argentina.
¹⁶ Department of Surgery, Centro de Educación Médica e Investigaciones Clínicas, Buenos Aires, Argentina.
¹⁷ Anal Neoplasia Clinic, Research, and Education Center, University of California, San Francisco, San Francisco, California, USA.
¹⁸ Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA.
¹⁹ Douglass Hanly Moir Pathology, Sydney, New South Wales, Australia.

PMID: 38297406
DOI: 10.1002/ijc.34850

International Anal Neoplasia Society's consensus guidelines for anal cancer screening

Elizabeth A Stier et al. Int J Cancer. 2024.

. 2024 May 15;154(10):1694-1702.

doi: 10.1002/ijc.34850. Epub 2024 Jan 31.

Authors

Affiliations

¹ Department of Obstetrics and Gynecology, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA.
² Division of Cancer Epidemiology & Genetics, National Cancer Institute, Rockville, Maryland, USA.
³ Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina, USA.
⁴ Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina, USA.
⁵ Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
⁶ The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.
⁷ Department of Public Health and Infectious Diseases, Policlinico Umberto I hospital-"Sapienza" University of Rome, Rome, Italy.
⁸ Department of Research, Fundación Huésped, Buenos Aires, Argentina.
⁹ Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
¹⁰ International Agency for Research on Cancer, Lyon, France.
¹¹ Department of Colorectal Surgery, Homerton University Hospital NHS Foundation Trust, London, UK.
¹² Icahn School of Medicine at Mount Sinai, New York, New York, USA.
¹³ St Vincent's Hospital, Sydney, New South Wales, Australia.
¹⁴ Department of Medicine/Division of Infectious Diseases, University of Miami, Miami, Florida, USA.
¹⁵ Centro Privado de Cirugía y Coloproctología, Buenos Aires, Argentina.
¹⁶ Department of Surgery, Centro de Educación Médica e Investigaciones Clínicas, Buenos Aires, Argentina.
¹⁷ Anal Neoplasia Clinic, Research, and Education Center, University of California, San Francisco, San Francisco, California, USA.
¹⁸ Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA.
¹⁹ Douglass Hanly Moir Pathology, Sydney, New South Wales, Australia.

PMID: 38297406
DOI: 10.1002/ijc.34850

Abstract

The International Anal Neoplasia Society (IANS) developed consensus guidelines to inform anal cancer screening use among various high-risk groups. Anal cancer incidence estimates by age among risk groups provided the basis to identify risk thresholds to recommend screening. Guided by risk thresholds, screening initiation at age 35 years was recommended for men who have sex with men (MSM) and transgender women (TW) with HIV. For other people with HIV and MSM and TW not with HIV, screening initiation at age 45 years was recommended. For solid organ transplant recipients, screening initiation beginning from 10 years post-transplant was recommended. For persons with a history of vulvar precancer or cancer, screening initiation was recommended starting within 1 year of diagnosis of vulvar precancer or cancer. Persons aged ≥45 years with a history of cervical/vaginal HSIL or cancer, perianal warts, persistent (>1 year) cervical HPV16, or autoimmune conditions could be considered for screening with shared decision-making, provided there is adequate capacity to perform diagnostic procedures (high-resolution anoscopy [HRA]). Anal cytology, high-risk (hr) human papillomavirus (HPV) testing (including genotyping for HPV16), and hrHPV-cytology co-testing are different strategies currently used for anal cancer screening that show acceptable performance. Thresholds for referral for HRA or follow-up screening tests are delineated. These recommendations from IANS provide the basis to inform management of abnormal screening results, considering currently available screening tools. These guidelines provide a pivotal foundation to help generate consensus among providers and inform the introduction and implementation of risk-targeted screening for anal cancer prevention.

Keywords: anal HPV; anal cancer; anal cancer screening; anal cytology.

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References

REFERENCES

1. Deshmukh AA, Damgacioglu H, Georges D, et al. Global burden of HPV-attributable squamous cell carcinoma of the anus in 2020, according to sex and HIV status: a worldwide analysis. Int J Cancer. 2023;152:417-428.
1. Clifford GM, Georges D, Shiels MS, et al. A meta-analysis of anal cancer incidence by risk group: toward a unified anal cancer risk scale. Int J Cancer. 2021;148:38-47.
1. Palefsky JM, Lee JY, Jay N, et al. Treatment of anal high-grade squamous intraepithelial lesions to prevent anal cancer. N Engl J Med. 2022;386:2273-2282.
1. Clarke MA, Deshmukh AA, Suk R, et al. A systematic review and meta-analysis of cytology and HPV-related biomarkers for anal cancer screening among different risk groups. Int J Cancer. 2022;151:1889-1901.
1. Deshmukh AA, Damgacioglu H, Georges D, Sonawane K, Clifford GM. Human papillomavirus-associated anal cancer incidence and burden among US men, according to sexual orientation, HIV status, and age. Clin Infect Dis. 2023;77:419-424.

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International Anal Neoplasia Society's consensus guidelines for anal cancer screening

Affiliations

International Anal Neoplasia Society's consensus guidelines for anal cancer screening

Authors

Affiliations

Abstract

References

REFERENCES

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical