Time: 2024-07-24
The integration of anal cytology with high - risk human papillomavirus ( HPV ) testing has proven to be more effective in identifying anal cancers and precancers in individuals with HIV than either test alone , a recent study has revealed . The study , presented at the International AIDS Conference in Munich by Michael Gaisa , MD , PhD , from the Icahn School of Medicine at Mount Sinai in New York City , highlighted the increased specificity and positive predictive value of combining these screening methods . Various screening strategies outlined by the International Anal Neoplasia Society ( IANS ) in 2024 , including anal cytology alone , cytology and high - risk HPV co - testing , among others , were analyzed to determine their effectiveness in real - world scenarios among people with HIV.
The study conducted by Gaisa and colleagues involved 1,620 individuals with HIV who underwent anal cancer screening using different methods between 2012 and 2019 . The findings indicated that while individual tests had high sensitivities ranging from 85 % to 96 % in detecting anal cancers or precancers , they lacked specificity , with cytology alone exhibiting just 30 % and high - risk HPV testing alone at 27 % . High - risk HPV testing alone showed the highest sensitivity ( 96 % ) but also resulted in a higher number of referrals for further evaluation . Screening strategies combining anal cytology with high - risk HPV testing were suggested to optimize test performance without compromising sensitivity , thereby streamlining the use of diagnostic resources.
The U.S. Centers for Disease Control and Prevention ( CDC ) recently released the first federal guidelines for anal cancer screening in individuals with HIV , a group at elevated risk for this type of cancer . These guidelines , based on data from the ANCHOR study , emphasize the importance of early detection and treatment of anal high - grade squamous intraepithelial lesions ( HSIL ) to prevent the development of anal cancer . The study , conducted across various medical centers , including Sylvester Comprehensive Cancer Center , found that treating potentially precancerous anal lesions can reduce the risk of developing anal cancer by about 60 % in individuals with HIV over active monitoring.
The implementation of the new CDC guidelines for anal cancer screening poses a significant challenge in terms of training clinicians and ensuring widespread coverage by insurance companies . While the guidelines primarily target the HIV population , other high - risk groups , such as organ transplant recipients and individuals with a history of HPV - related conditions , may also benefit from regular screenings . The shift towards increased screening for anal cancer holds promise for reducing the burden of this disease and improving outcomes for individuals at risk , ultimately leading to better overall health outcomes within these vulnerable populations.
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