HPV can lead to anal cancer, but it's preventable! Get vaccinated between ages 9-26 and talk to your doctor about anal cancer screening if you're HIV positive.
Anal cancer, while less common than other cancers, poses a significant threat to people living with HIV. Weakened immune systems make them more susceptible to the human papillomavirus (HPV), the primary culprit behind anal cancer.
However, a recent breakthrough offers a beacon of hope: new national guidelines in the US recommend screening and treatment strategies specifically designed to benefit this population.
This development stems from the groundbreaking Anal Cancer HSIL Outcomes Research (ANCHOR) trial led by the University of California, San Francisco (UCSF). The study's findings, published in the New England Journal of Medicine in 2022, were a game-changer.
Researchers compared two groups: one received treatment for high-grade squamous intraepithelial lesions (HSIL), a precancerous anal cell abnormality, while the other underwent monitoring only. The results were clear; treatment significantly reduced the risk of anal cancer development by a staggering 60% in people with HIV.
Stay tuned to learn more.
Why are people with HIV at higher risk?
HPV is a sexually transmitted infection with various strains. Some strains cause genital warts, while others can trigger precancerous and cancerous changes in cells. People with HIV have a weakened immune system, making it harder for their bodies to clear HPV infections. This prolonged exposure to certain HPV strains increases their risk of developing anal cancer.
New screening recommendations
The new guidelines, published by a panel of HIV care experts in July 2024, represent a critical step forward in anal cancer prevention for people with HIV. Here's a breakdown of the key recommendations:
- Screening age: The recommended starting age for screening varies based on risk factors. Men who have sex with men (MSM) and transgender women who have sex with men should begin screening at age 35. For women and men who do not have sex with men, the recommended starting age is 45.
- Screening process: The screening process involves a combination of tests:
- Anal cytology (Pap test): This test collects cells from the anus to be examined for abnormalities.
- High-resolution anoscopy (HRA): This minimally invasive procedure uses a magnified scope to examine the anal canal for visible signs of precancerous lesions.
Treatment options and importance of follow-up
If the screening tests detect HSIL, treatment options are available to remove or destroy the abnormal cells before they have a chance to progress to cancer. These options may include:
- Infrared coagulation: This procedure uses heat to destroy abnormal tissue.
- Cryotherapy: This technique freezes and destroys abnormal cells.
- Surgical excision: In some cases, removal of the abnormal tissue may be necessary.
Following a positive HSIL diagnosis, regular follow-up appointments are crucial to monitor for recurrence and ensure the effectiveness of treatment.
What this means for you
The new anal cancer screening recommendations empower people with HIV to take a proactive approach to their health. Here are some key takeaways:
- Talk to your doctor: If you are 35 or older and living with HIV, discuss anal cancer screening with your healthcare provider. They can assess your individual risk factors and determine the best course of action.
- Vaccination is key: While not a substitute for screening, HPV vaccination can significantly reduce your risk of developing anal cancer. The Centers for Disease Control and Prevention (CDC) recommends HPV vaccination for all individuals between the ages of 9 and 26, regardless of HIV status.
- Early detection saves lives: Anal cancer is highly treatable when caught early. Regular screenings and follow-up appointments are essential for early detection and successful treatment.
The new anal cancer screening guidelines are a significant victory in the fight against this preventable cancer. By raising awareness, encouraging early detection, and promoting HPV vaccination, we can empower people with HIV to live longer, healthier lives.
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