Screening for anal cancer: Endpoints needed

摘要

Anal cancer is very rare in the general population, but much more common in well defined, high-risk populations, including women with a previous cervical precancer, men who have sex with men (MSM), and individuals with HIV. Infection with carcinogenic human papillomavirus (HPV) has been increasingly recognised to cause anal cancer. In The Lancet Oncology, Dorothy Machalek and colleagues report their findings from a systematic review and meta-analysis of anal HPV infection and associated lesions in MSM, underscoring the disease burden in HIV-positive MSM.1 They recorded a prevalence of high-risk anal HPV in HIV-positive MSM of 73.5% (95% Cl 63.9-83.0). In the same population, the prevalence of high-grade anal intraepithelial neoplasia (AIN) was 29.1% (22.8-35.4) and the estimated annual cancer incidence was 45.9 per 100 000 HIV-positive MSM (95% Cl 31.2-60.3).