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

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

Metadata
Organisation: Stier, Elizabeth A. Department of Obstetrics and Gynecology, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA. Clarke, Megan A. Division of Cancer Epidemiology & Genetics, National Cancer Institute, Rockville, Maryland, USA. Deshmukh, Ashish A. Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina, USA. Deshmukh, Ashish A. Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina, USA. Wentzensen, Nicolas. Division of Cancer Epidemiology & Genetics, National Cancer Institute, Rockville, Maryland, USA. Liu, Yuxin. Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York, USA. Poynten, I Mary. The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia. Cavallari, Eugenio Nelson. Department of Public Health and Infectious Diseases, Policlinico Umberto I hospital-"Sapienza" University of Rome, Rome, Italy. Fink, Valeria. Department of Research, Fundacion Huesped, Buenos Aires, Argentina. Barroso, Luis F. Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA. Clifford, Gary M. International Agency for Research on Cancer, Lyon, France. Cuming, Tamzin. Department of Colorectal Surgery, Homerton University Hospital NHS Foundation Trust, London, UK. Goldstone, Stephen E. Icahn School of Medicine at Mount Sinai, New York, New York, USA. Hillman, Richard J. The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia. Hillman, Richard J. St Vincent's Hospital, Sydney, New South Wales, Australia. Rosa-Cunha, Isabela. Department of Medicine/Division of Infectious Diseases, University of Miami, Miami, Florida, USA. La Rosa, Luciana. Centro Privado de Cirugia y Coloproctologia, Buenos Aires, Argentina. La Rosa, Luciana. Department of Surgery, Centro de Educacion Medica e Investigaciones Clinicas, Buenos Aires, Argentina. Palefsky, Joel M. Anal Neoplasia Clinic, Research, and Education Center, University of California, San Francisco, San Francisco, California, USA. Plotzker, Rosalyn. Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA. Roberts, Jennifer M. Douglass Hanly Moir Pathology, Sydney, New South Wales, Australia. Jay, Naomi. Anal Neoplasia Clinic, Research, and Education Center, University of California, San Francisco, San Francisco, California, USA.
Publication type: Guideline
Organ: Kidney; Pancreas; Liver; Simultaneous Kidney/Pancreas; Heart; Heart/Lung; Lung; Intestine; Various
Language: English
MeSH terms: Male; Humans; Female; Adult; Middle Aged; Homosexuality, Male; Papillomavirus Infections; Early Detection of Cancer; Sexual and Gender Minorities; Anus Neoplasms; Human papillomavirus 16; HIV Infections; Papillomaviridae; Human Papillomavirus 16; Heart Transplantation; Heart-Lung Transplantation; Kidney Transplantation; Lung Transplantation; Liver Transplantation; Pancreas Transplantation