December 15, 2009
The current review discusses issues around screening to prevent anal cancer. "The incidence of human papillomavirus-associated anal cancer is unacceptably high among HIV-positive men who have sex with men, and possibly in HIV-positive women," Palefsky wrote. He noted that anal cancer, unlike most other malignancies found among the HIV-positive population, "is potentially preventable, using methods similar to those used to prevent cervical cancer in women."
According to recent studies, the incidence of anal cancer has increased since the introduction of highly active antiretroviral therapy in this population "and now exceeds the highest incidence of cervical cancer among women reported anywhere in the world," Palefsky wrote.
"The high incidence of anal cancer among HIV-positive individuals must not be ignored, since it may be preventable. Given the current evidence and analogy with the cervical cancer prevention model, many clinicians believe that identification and treatment of high-grade anal intraepithelial neoplasia to prevent anal cancer are warranted," Palefsky wrote in conclusion. "When the expertise to do so exists, this is a reasonable approach, particularly if coupled with efforts to optimize further screening and treatment approaches, as well as efforts to document the efficacy of high-grade anal intraepithelial neoplasia treatment to reduce the incidence of anal cancer."