International Anal Neoplasia Society consensus guidelines for anal cancer screening
The first international guideline on who should be screened for anal cancer and how, written after the ANCHOR trial showed that treating precancer prevents the disease.
Overview
Consensus guideline from the International Anal Neoplasia Society setting out the groups at highest risk of anal cancer and a screening pathway of anal cytology, high-risk HPV testing or both, followed by high-resolution anoscopy for abnormal results.
Screening is recommended from age 35 for men who have sex with men and transgender women living with HIV, from 45 for other people living with HIV and for men who have sex with men and transgender women not living with HIV, and for solid organ transplant recipients and women with a history of vulvar HSIL or cancer, with thresholds for referral to anoscopy that depend on local capacity.
For the first time clinicians have an agreed answer to who to screen for anal cancer and at what age, so that treatment of HSIL can reach the people most likely to benefit.
- High-resolution anoscopy is scarce outside specialist centres, and the guideline allows different referral thresholds where capacity is limited.
- Evidence for screening people at high risk who do not have HIV is indirect.