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

• Published in: International journal of cancer Vol. 154; no. 10; pp. 1694 - 1702
• Main Authors: Stier, Elizabeth A., Clarke, Megan A., Deshmukh, Ashish A., Wentzensen, Nicolas, Liu, Yuxin, Poynten, I. Mary, Cavallari, Eugenio Nelson, Fink, Valeria, Barroso, Luis F., Clifford, Gary M., Cuming, Tamzin, Goldstone, Stephen E., Hillman, Richard J., Rosa‐Cunha, Isabela, La Rosa, Luciana, Palefsky, Joel M., Plotzker, Rosalyn, Roberts, Jennifer M., Jay, Naomi
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 15.05.2024
• Subjects: Adult; Age; Anal cancer; Anus; Anus Neoplasms; Cancer; Cancer screening; Cellular biology; Cytology; Decision making; Disease prevention; Early Detection of Cancer; Female; Gays & lesbians; Genotyping; Health risks; HIV; HIV Infections; Homosexuality, Male; Human immunodeficiency virus; Human papillomavirus; Human papillomavirus 16; Humans; Male; Medical diagnosis; Medical screening; Middle Aged; Papillomaviridae; Papillomavirus Infections; Risk groups; Sexual and Gender Minorities; Transgender persons; anal HPV; anal cancer screening; anal cancer; anal cytology
• ISSN: 0020-7136; 1097-0215; 1097-0215
• DOI: 10.1002/ijc.34850

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.