Anal high-grade squamous intraepithelial lesions (precursor): lines of therapy

Cancer page →

4 standard-of-care settings across 2 lines and 1 biomarker subgroup. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.

Line	All comers
Screening, prevention and diagnosis	2
Other settings	2

Screening, prevention and diagnosis

Subgroup	Setting	Approach	Products and trials	Guideline	Evidence
All comers	Screening	Anal cytology or high-risk HPV testing followed by high-resolution anoscopy in people living with HIV and other high-risk groups, following the 2024 International Anal Neoplasia Society guidelines.	HPV DNA testing and self-samplingHPV-positive (p16) head and neck cancerCirculating tumour HPV DNA (ctHPV-DNA)	NCCN Guidelines: Anal Carcinoma	40
All comers	Prevention	HPV vaccination, which protects against the HPV types that cause almost all anal cancer.	HPV & HBV vaccinationNonavalent HPV vaccine	NCCN Guidelines: Anal Carcinoma	86

Other settings

Subgroup	Setting	Approach	Products and trials	Guideline	Evidence
All comers	Treatment of HSIL	Office-based ablation (electrocautery, infrared coagulation) for discrete lesions; topical fluorouracil or imiquimod for extensive or perianal disease; excision for lesions where invasion is suspected (ANCHOR).	Thermal ablation and cryotherapy for cervical precancerFluorouracil (5-FU)	NCCN Guidelines: Anal Carcinoma	82
All comers	After treatment	Repeat high-resolution anoscopy because recurrence is common; biopsy of any lesion that changes or ulcerates.	HPV DNA testing and self-samplingHPV-positive (p16) head and neck cancer	NCCN Guidelines: Anal Carcinoma	40

Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.