New Anal Cancer Screening Guidelines for People with HIV

Men who have sex with men (MSM) with HIV are 80-130 times more likely to develop anal cancer than MSM without HIV. Despite widespread effective antiretroviral therapy, anal cancer incidence and anal cancer mortality is rising among men and women with HIV. In July 2024, long awaited, practice-changing anal cancer screening guidelines for persons with HIV were released.

Dr. Brian Wood reviews anal cancer risk factors and the influential ANCHOR trial which informed the new guidelines before discussing various screening algorithms if a person does has anal symptoms or is asymptomatic. The algorithms include when to perform a digital anorectal exams (DARE), a standard anoscopy, anal Pap, and HPV co-testing, as well as when to refer for high resolution anoscopy (HRA).