Materiały źródłowe

• #1 Anal cancer – HIV Management Guidelines

  https://hiv.guidelines.org.au/management/human-papillomavirus-infection-and-associated-malignancies-in-hiv-infected-people/anal-cancer/

  Anal cancer is defined as a cancer arising either from the squamous or glandular epithelium of the anus. The vast majority are SCCs (36), with the remainder coded as adenocarcinomas, neuroendocrine neoplasm, malignant melanoma, mesenchymal tumours and lymphoma (36-39). Anal cancers are distinguished anatomically as being of the anal canal (arising from the canal which extends between the rectum to perianal skin) or perianal (arising from the skin within 5 cm diameter from the anal verge) (Figure 3). […] Anal cancer is relatively rare in the general population with incidence rates between 1 to 2 per 100,000 person-years, though rates are rising over time (Figure 4) (36, 38, 41-43). However, for men who have sex with men (MSM) who have HIV infection, a recent meta-analysis estimated a pooled incidence rate of 77.8 per 100,000 person-years (44). This is comparable with other common cancers in the general Australian population (45).

• #1 Anal Cancer Risks: Preventing the Chance of Getting Cancer of the Anus – Cleveland OH | University Hospitals

  https://www.uhhospitals.org/services/cancer-services/gastrointestinal-cancer/anal-cancer/prevention

  Avoiding risk factors and increasing protective factors may help prevent cancer. […] The following are risk factors for anal cancer: Anal HPV infection, Certain medical conditions, Certain sexual practices, Cigarette smoking. […] The following protective factor decreases the risk of anal cancer: HPV vaccine. […] Cancer prevention clinical trials are used to study ways to prevent cancer. […] New ways to prevent anal cancer are being studied in clinical trials.

• #1 Prophylactic HPV vaccination and anal cancer

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4964669/

  The incidence of anal cancer is increasing. High risk populations include HIV-positive men who have sex with men (MSM), HIV-negative MSM, HIV-positive women and heterosexual men and women with a history of cervical cancer. HPV has been detected in over 90% of anal cancers. The quadrivalent HPV (qHPV) vaccine has been demonstrated to prevent vaccine associated persistent anal HPV infections as well as anal intraepithelial neoplasia grades 2-3 (AIN2+) in young MSM not previously infected. […] The 9-valent HPV vaccine, when administered to boys and girls prior to the onset of sexual activity, should effectively prevent anal cancer. […] In summary, administering the 9-valent HPV vaccine to girls and boys prior to the onset of sexual activity could effectively prevent almost all anal cancers (primary prevention of SCCA). In addition, the 9v HPV vaccine may be helpful in preventing recurrent AIN2+ and possibly the progression to SCCA, especially in individuals at increased risk for SCCA including all HIV-positive men and women, HIV-negative MSM, and women with history of CIN3 or cervical cancer.

• #1 Anal Cancer Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/2500052-treatment

  Prevention begins with recognition of the risk factors for anal cancer, which are as follows: Anal human papillomavirus (HPV) infection, a history of vulvar, cervical, or vaginal cancer or precancerous lesions in women, HIV infection, immunosuppression (eg, in organ transplant recipients, individuals with autoimmune diseases), certain sexual practices (receptive anal intercourse, having many sexual partners, sex between men), and cigarette smoking. […] Strategies for prevention of anal squamous cell carcinoma consist of vaccination against HPV and management of anal intraepithelial neoplasia (AIN). In the United States, 91% of anal cancers have been found to be positive for HPV, with HPV subtype 16 most commonly detected. […] Initially approved in 2014, the 9-valent HPV vaccine (Gardasil 9 [9vHPV]) is the only HPV vaccine available in the US. The 9vHPV vaccine covers HPV subtypes 6, 11, 16, 18, 31, 33, 45, 52, and 58. It is indicated for males and females aged 9 through 45 years to prevent anal cancer caused by HPV types 16, 18, 31, 33, 45, 52, and 58.

• #1 Anal cancer – HIV Management Guidelines

  https://hiv.guidelines.org.au/management/human-papillomavirus-infection-and-associated-malignancies-in-hiv-infected-people/anal-cancer/

  Squamous cell carcinoma is the commonest (85%) form of anal cancer and is primarily caused by HPV infection (46-49). Additional risk factors are receptive anal intercourse (before the age of 30) (49-51), higher lifetime number of sexual partners (50, 51), current cigarette smoking (48, 52, 53), genital warts (50, 53), and immunosuppression (HIV, post-organ transplantation) (49, 54-56). Anal fistulae and epithelial trauma may also be associated, possibly because they increase access of HPV to the basement membrane (57-59). […] Screening There are no consistent guidelines on how to screen for anal cancer or pre-cancerous lesions. If available, anal cytology with or without high resolution anoscopy has been recommended to detect anal cancer precursor lesions (analogous to cervical cancer) (65). There is ongoing research (including a large randomized controlled trial in the United States) to determine the effectiveness of this screening modality.

• #1

  https://www.healthbanks.com/PatientPortal/MyPractice.aspx?UAID=C02C9140-EE45-4012-81AE-26B3E0C445ED&ID=HW5ncicdr0000755833

  Human papillomavirus (HPV) infection is the strongest risk factor for anal cancer and is accepted as a causal agent of squamous cell carcinoma of the anus and its precursor lesions. […] Based on solid evidence, HPV infection causes squamous cell carcinoma of the anus. […] Based on solid evidence, behaviors or medical conditions that either indicate HPV infection or facilitate HPV transmission or persistence increase the risk or are associated with increased risk of anal cancer. […] Based on solid evidence, cigarette smoking increases the risk of anal cancer. […] Based on solid evidence, HPV vaccination of men aged 16 to 26 years who have sex with men in the year before vaccination reduces anal intraepithelial neoplasia (AIN), a precursor lesion of anal cancer. […] Because HPV is a causal condition for squamous cell anal cancer development, vaccination against the oncogenic strains of HPV before exposure may reduce the risk of anal cancer.

• #1 Anal Cancer Prevention – NCI

  https://www.cancer.gov/types/anal/patient/anal-prevention-pdq

  Anal cancer is a disease in which malignant (cancer) cells form in the tissues of the anus. […] Squamous cell carcinoma is the most common type of anal cancer. […] In the United States, the number of new cases of anal cancer has increased in recent years. […] Avoiding risk factors and increasing protective factors may help prevent cancer. […] The following are risk factors for anal cancer: Anal HPV infection, Certain medical conditions, Certain sexual practices, Cigarette smoking. […] The following protective factors decrease the risk of anal cancer: HPV vaccination, Screening for anal cancer using anoscopy, Treatment of anal lesions. […] Studies show that being vaccinated against HPV lowers the risk of anal cancer. […] Studies suggest that using anoscopy to screen for anal cancer could reduce the number of deaths from the disease in people who are HIV positive.

• #1 Anal Cancer Prevention (PDQ®) – NCI

  https://www.cancer.gov/types/anal/hp/anal-prevention-pdq

  Human papillomavirus (HPV) infection is the strongest risk factor for anal cancer and is accepted as a causal agent of squamous cell carcinoma of the anus and its precursor lesions. […] Based on solid evidence, HPV vaccination of men aged 16 to 26 years who have sex with men in the year before vaccination reduces anal intraepithelial neoplasia (AIN), a precursor lesion of anal cancer. […] Based on solid evidence, treating anal HSIL prevents anal cancer in HIV-positive individuals older than 35 years. When compared with the active monitoring arm, active HSIL treatment was associated with a decreased progression to anal cancer incidence by 57%. […] Because human papillomavirus (HPV) is a causal condition for squamous cell anal cancer development, vaccination against the oncogenic strains of HPV before exposure may reduce the risk of anal cancer.

• #1 Reducing your risk for anal cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/anal/risks/reducing-your-risk

  You may lower your risk of developing anal cancer by doing the following. […] HPV infection is the main risk factor for anal cancer. The 3 HPV vaccines available in Canada are Gardasil, Gardasil 9 and Cervarix. These vaccines help protect against infection with HPV16 and HPV18, the 2 types of HPV most commonly associated with cancer. Gardasil and Gardasil 9 are approved to help prevent precancerous conditions of the anus and anal cancer associated with HPV infection. […] Get vaccinated or have your children vaccinated through school-based programs where available. […] The only sure way to prevent HPV infection is to completely avoid any genital contact with another person. […] If you are sexually active, use a condom to help protect against HPV. […] Smoking tobacco increases the risk of precancerous conditions and cancer of the anus. […] Some people can have a higher than average risk for anal cancer. Talk to your doctor about your risk. If you are at higher than average risk, you may need to visit your doctor more often to check for anal cancer.

• #1 Anal Cancer Prevention (PDQ®): Prevention – Patient Information [NCI] | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.anal-cancer-prevention-pdq%C2%AE-prevention-patient-information-nci.ncicdr0000755491

  The following protective factors decrease the risk of anal cancer: HPV vaccination. HPV vaccines help protect the body against infection with certain types of HPV. They are used to prevent anal cancer, cervical cancer, vulvar cancer, vaginal cancer, and some other types of cancer caused by HPV. […] Studies show that being vaccinated against HPV lowers the risk of anal cancer. The vaccine may work best when it is given before a person is exposed to HPV. […] Studies suggest that using anoscopy to screen for anal cancer could reduce the number of deaths from the disease in people who are HIV positive. […] Studies show that treatment of anal high-grade squamous intraepithelial lesions (HSIL) decreases the development of anal cancer in people who are HIV positive. […] Cancer prevention clinical trials are used to study ways to lower the risk of developing certain types of cancer. […] New ways to prevent anal cancer are being studied in clinical trials.

• #1

  https://winshipcancer.emory.edu/cancer-types-and-treatments/anal-cancer/prevention.php

  Most anal cancers stem from human papillomavirus infection, which means the key to anal cancer prevention may lie largely in HPV vaccination. […] As such, researchers believe the key to anal cancer prevention may lie in HPV vaccination and other risk factor reduction. […] Most anal cancers can be avoided by adhering to the following anal cancer prevention guidelines from the American Cancer Society: […] Get vaccinated against HPV. The vaccine is recommended for males and females ages 9 to 45. The vaccine does not treat existing HPV infection; it can only prevent one from occurring. Thats why its important to get children vaccinated prior to initiation of sexual activity. […] Not smoking. […] Managing HIV with strict medication adherence. […] Using condoms with all sexual activity in individuals with multiple sexual partners.

• #1 What is the HPV Vaccine? | The Anal Cancer Foundation

  https://www.analcancerfoundation.org/what-is-anal-cancer/hpv-vaccine/

  The HPV vaccine protects against the human papillomavirus, which can cause various cancers. […] The vaccine became available in 2006. […] In the US, it is recommended that both male and female children aged 11-12 be vaccinated against HPV. […] In the UK, girls and boys aged 12 to 13 years will be routinely offered the first HPV vaccination when they’re in school Year 8. […] Both the FDA (US) and NHS (UK) recommend that even people infected with one strain of the virus should be vaccinated if they are in the recommended age bracket. […] Of all HPV-associated cancers, these two HPV strains cause 70% of cervical carcinomas, 91% of anal cancer, 80% of vulvar and vaginal cancers, 63% of penile cancer and 89% of oropharyngeal cancers. […] Gardasil 9 is indicated by the FDA for the following:

• #1 Causes of anal cancer – NHS

  https://www.nhs.uk/conditions/anal-cancer/causes/

  Most anal cancers are caused by an infection called human papillomavirus (HPV). […] You cannot always prevent anal cancer. HPV vaccination is one of the best ways to protect against anal cancer. […] All children aged 12 to 13 are offered the HPV vaccine. It helps protect against cancers caused by HPV, as well as genital warts. […] The HPV vaccine is also recommended for other groups at higher risk of getting HPV, including: men aged 45 years old and under who have sex with men, trans men and trans women aged 45 years old and under if their risk of getting HPV is the same as men who have sex with men, sex workers, people with HIV. […] There are also healthy changes you can make to lower your chances of getting anal cancer. […] use a condom when having sex to lower your chances of getting HPV […] keep sex toys clean and do not share them […] try to quit smoking.

• #1 Anal Cancer Prevention (PDQ®): Prevention – Health Professional Information [NCI] | Cigna

  https://www.cigna.com/knowledge-center/hw/medical-topics/anal-cancer-prevention-ncicdr0000755833

  Human papillomavirus (HPV) infection is the strongest risk factor for anal cancer and is accepted as a causal agent of squamous cell carcinoma of the anus and its precursor lesions. […] Based on solid evidence, HPV vaccination of men aged 16 to 26 years who have sex with men in the year before vaccination reduces anal intraepithelial neoplasia (AIN), a precursor lesion of anal cancer. […] Based on solid evidence, treating anal HSIL prevents anal cancer in HIV-positive individuals older than 35 years. When compared with the active monitoring arm, active HSIL treatment was associated with a decreased progression to anal cancer incidence by 57%. […] Because human papillomavirus (HPV) is a causal condition for squamous cell anal cancer development, vaccination against the oncogenic strains of HPV before exposure may reduce the risk of anal cancer. […] Data strongly suggest that vaccination against oncogenic HPV strains will lead to reductions in anal cancer. They also suggest that vaccination before exposure will provide the most benefit.

• #1 Panel Issues First Guidelines to Prevent Anal Cancer in People With HIV | UC San Francisco

  https://www.ucsf.edu/news/2024/07/428076/panel-issues-first-guidelines-prevent-anal-cancer-people-hiv

  Results from a national study led by UC San Francisco informed the first guidelines at the federal level in the U.S. to detect and treat anal cancer precursor lesions in people with HIV to reduce the risk of developing anal cancer. […] The ANCHOR trial, conducted at 25 clinical sites around the country and published in the New England Journal of Medicine in 2022, found that routine screening for and removal of precancerous anal lesions could significantly reduce the risk of anal cancer, in much the way that cervical cancer is prevented in women. […] With this new recommendation, we hope that screening for anal cancer becomes a routine procedure in the care of people with HIV. […] I strongly encourage people with HIV to discuss anal cancer screening with their primary care providers. […] Under the new guidelines, if high-resolution anoscopy is available, certain adults with HIV starting at age 35 for men, and transgender women, who have sex with men; and starting at 45 for women and men who do not have sex with men should undergo screening for anal cancer precursor lesions with laboratory testing of an anal swab sample, and a digital anorectal examination to feel for changes that might indicate the presence of a cancer.

• #1 Treating anal cancer precursor lesions reduces cancer risk for people with HIV

  https://medicalxpress.com/news/2021-10-anal-cancer-precursor-lesions-people.html

  In a randomized clinical trial with 4,446 participants, known as the Anal Cancer/HSIL Outcomes Research (ANCHOR) study, researchers found that by removing high-grade squamous intraepithelial lesions (HSIL), chances of progression to anal cancer were significantly reduced. […] The study caps decades of research into the history, prevention and treatment of anal cancer and its precursors. It also provides important information for developing standard of care guidelines for people at high risk of anal cancer, including screening for and treatment of anal HSIL, said lead investigator Joel Palefsky, MD, a professor of medicine at UCSF. […] „ANCHOR data show for the first time that, like cervical cancer, anal cancer can be prevented even in high-risk populations, such as people living with HIV, who often have HSIL that can be difficult to treat,” Palefsky said. […] The principal reason to consider HSIL treatment is to reduce the risk of developing anal cancer. The ANCHOR study will provide key information in guiding recommendations to make anal cancer prevention programs the standard of care for people at high risk of anal cancer.

• #1 Anal Cancer Prevention – NCI

  https://www.cancer.gov/types/anal/patient/anal-prevention-pdq

  Studies show that treatment of anal high-grade squamous intraepithelial lesions (HSIL) decreases the development of anal cancer in people who are HIV positive. […] It is not known if the use of condoms protects against anal HPV infection. […] Cancer prevention clinical trials are used to study ways to prevent cancer. […] New ways to prevent anal cancer are being studied in clinical trials.

• #1 Anal Cancer Guidelines: Guidelines Summary, ASCRS Practice Parameters, NCCN Guidelines

  https://emedicine.medscape.com/article/2500052-guidelines

  Topical imiquimod, fluorouracil, trichloroacetic acid, or cidofovir, with close long-term follow-up, are options for the treatment of low-grade or high-grade squamous intraepithelial lesions. (Weak recommendation based on moderate-quality evidence, 2B) […] Vaccination against human papillomavirus (HPV) in men and women under age 26 years for primary prevention is typically recommended; Vaccination of individuals with anal dysplasia for secondary prevention of dysplasia and cancer is not recommended. (Weak recommendation based on high-quality evidence, 2A) […] Patients who have been treated for anal dysplasia may be observed without regular cytology, HPV testing, or anoscopy; however, treatment of visible or palpable disease should be offered. (Weak recommendation based on low or very low-quality evidence, 2C)

• #1 Anal Cancer Risk Factors & Prevention | The Anal Cancer Foundation

  https://www.analcancerfoundation.org/what-is-anal-cancer/prevention/

  Stopping smoking reduces your risk of developing many cancers, including anal cancer. […] Screening is important for people who are past the recommended age range for the vaccine. Even with vaccination, it is important to continue regular screening. This is because you may have been exposed to a strain of the virus not covered by the vaccine, or you may have been exposed before being vaccinated.

• #1 Anal Cancer Risk Factors & Prevention | The Anal Cancer Foundation

  https://www.analcancerfoundation.org/what-is-anal-cancer/prevention/

  The following anal cancer prevention information is provided to help you understand the risk factors and learn about the preventative measures you can undertake to reduce your chances of getting anal cancer. […] Vaccines exist to protect individuals from the most cancer-causing strains of the virus. HPV is the cause of anal cancer 93% of the time. It also causes at least five other cancers, including cervical cancer. Since it is likely most people will have at least one intimate partner during their lifetime, HPV vaccination, screening and practising safe sex are important steps that will help reduce the chance of getting HPV and anal cancer. […] To decrease the risk of transmitting HPV it is important to practise safe sex and use a condom. […] For individuals with HIV, maintaining antiretroviral therapy will help keep the immune system strong.

• #1 Anal cancer – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/anal-cancer/symptoms-causes/syc-20354140

  Anal cancer happens when cells in the anal canal develop changes in their DNA. […] Most anal cancers are thought to be caused by human papillomavirus, also called HPV. HPV is a common virus that’s passed through sexual contact. […] To reduce your risk of anal cancer: Practice safer sex. Reduce your risk of anal cancer by taking measures to prevent sexually transmitted infections. This may include using a condom every time you have sex and limiting the number of sexual partners you have. […] Consider the HPV vaccine. Receiving a vaccination to prevent HPV infection may reduce your risk of anal cancer and other HPV-related cancers. […] Ask about anal cancer screening. Screening tests can help detect anal cancer and precancerous cells that may one day develop into anal cancer.

• #1 Anal Cancer Risk Cancer and Prevention | Banner Health

  https://www.bannerhealth.com/services/cancer/cancer-type/anal-cancer/risk-factors-and-prevention

  Limit the number of sexual partners you have, and wait until you are older to start having sex. […] Avoid sexually transmitted diseases. Limit your exposure to sexually transmitted diseases by avoiding having anal sex with people who have sexually transmitted diseases (STDs) and/or have had multiple sexual partners. […] Quit smoking or dont start. Smoking is a risk factor for many cancer types and living a tobacco-free life will greatly reduce your chance of developing cancer. […] Use condoms when having sex with a partner until you have both been tested for HPV, HIV and any other sexually transmitted disease. This applies to both anal and vaginal intercourse.

• #1 Can Anal Cancer Be Prevented? | Preventing Anal Cancer | American Cancer Society

  https://www.cancer.org/cancer/types/anal-cancer/causes-risks-prevention/prevention.html

  Condom use […] Condoms may provide some protection against HPV (and HIV), but they do not prevent infection completely. Given this, it is unclear if condom use can reduce the risk of anal cancer. […] One study found that when condoms are used correctly they can lower the genital HPV infection rate in women but they must be used every time sex occurs. […] Condoms cannot protect completely because they do not cover every possible HPV-infected area of the body, such as skin of the genital or anal area. HPV can still be passed from one person to another by skin to skin contact with an HPV-infected area of the body that is not covered by a condom. Still, condoms may provide some protection against HPV.

• #1 Anal Cancer – Prevention

  https://ruesch.georgetown.edu/analcancerprevention/

  Anal cancer prevention is action taken to lower the chance of getting cancer. […] Avoiding risk factors and increasing protective factors may help prevent cancer. […] The following are risk factors for anal cancer: Anal HPV infection, certain medical conditions, certain sexual practices, and cigarette smoking. […] The following protective factor decreases the risk of anal cancer: HPV vaccine. […] Cancer prevention clinical trials are used to study ways to prevent cancer. […] New ways to prevent anal cancer are being studied in clinical trials. […] Studies show that being vaccinated against HPV lowers the risk of anal cancer.

• #1

  https://winshipcancer.emory.edu/cancer-types-and-treatments/anal-cancer/prevention.php

  Winship is dedicated to curing cancer through its tireless research to improve the ways the world prevents, detects, diagnoses, treats and survives all types of cancer, including anal cancer. Thats why Winship is involved in research to better understand why anal cancer develops and to discover new ways to prevent it.

• #1 Anal Cancer Prevention in HIV Patients – Golden Rule Services

  https://sacgrs.org/news/anal-cancer-prevention-in-hiv-patients/

  New national guidelines for anal cancer prevention in HIV patients based on UCSF research. […] Results from a national study led by UC San Francisco informed the first guidelines at the federal level in the United States to detect and treat anal cancer precursor lesions in people with HIV to reduce the risk of developing anal cancer. […] The guidelines were published on July 9 by a panel of experts in HIV care, utilizing findings from the Anal Cancer/HSIL Outcomes Research (ANCHOR) trial led by Joel M. Palefsky, MD, a professor of medicine in the UCSF Infectious Disease Division.

• #1 Anal Cancer Prevention | NY | Montefiore Einstein Comprehensive Cancer Center

  https://montefioreeinstein.org/cancer/types/gastrointestinal/anal-prevention

  Anal cancer prevention is the goal of our world-renowned gastrointestinal oncology team. We are one of only a few hospitals to offer a highly specialized screening called high-resolution anoscopy to check for pre-cancerous lesions. If found, these lesions can be removed to prevent cancer from forming. […] There are many things you can do to lower your chances of developing anal cancer. You can start by getting the HPV vaccine, which protects against infection that increases the risk of cancer. Additionally, quitting smoking lowers your risk of developing anal cancer. You can also understand your family health history, choose healthy nutrition and add exercise to your daily routine. It’s important to identify cancer in its earliest stage and getting a cancer screening can help. […] Avoiding risk factors and increasing protective factors may help prevent cancer.

• #2 Anal Cancer Prevention (PDQ®) – NCI

  https://www.cancer.gov/types/anal/hp/anal-prevention-pdq

  Human papillomavirus (HPV) infection is the strongest risk factor for anal cancer and is accepted as a causal agent of squamous cell carcinoma of the anus and its precursor lesions. […] Based on solid evidence, HPV vaccination of men aged 16 to 26 years who have sex with men in the year before vaccination reduces anal intraepithelial neoplasia (AIN), a precursor lesion of anal cancer. […] Based on solid evidence, treating anal HSIL prevents anal cancer in HIV-positive individuals older than 35 years. When compared with the active monitoring arm, active HSIL treatment was associated with a decreased progression to anal cancer incidence by 57%. […] Because human papillomavirus (HPV) is a causal condition for squamous cell anal cancer development, vaccination against the oncogenic strains of HPV before exposure may reduce the risk of anal cancer.

• #2 Anal Cancer – Prevention

  https://ruesch.georgetown.edu/analcancerprevention/

  Anal cancer prevention is action taken to lower the chance of getting cancer. […] Avoiding risk factors and increasing protective factors may help prevent cancer. […] The following are risk factors for anal cancer: Anal HPV infection, certain medical conditions, certain sexual practices, and cigarette smoking. […] The following protective factor decreases the risk of anal cancer: HPV vaccine. […] Cancer prevention clinical trials are used to study ways to prevent cancer. […] New ways to prevent anal cancer are being studied in clinical trials. […] Studies show that being vaccinated against HPV lowers the risk of anal cancer.

• #2 Anal Cancer Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/2500052-treatment

  Prevention begins with recognition of the risk factors for anal cancer, which are as follows: Anal human papillomavirus (HPV) infection, a history of vulvar, cervical, or vaginal cancer or precancerous lesions in women, HIV infection, immunosuppression (eg, in organ transplant recipients, individuals with autoimmune diseases), certain sexual practices (receptive anal intercourse, having many sexual partners, sex between men), and cigarette smoking. […] Strategies for prevention of anal squamous cell carcinoma consist of vaccination against HPV and management of anal intraepithelial neoplasia (AIN). In the United States, 91% of anal cancers have been found to be positive for HPV, with HPV subtype 16 most commonly detected. […] Initially approved in 2014, the 9-valent HPV vaccine (Gardasil 9 [9vHPV]) is the only HPV vaccine available in the US. The 9vHPV vaccine covers HPV subtypes 6, 11, 16, 18, 31, 33, 45, 52, and 58. It is indicated for males and females aged 9 through 45 years to prevent anal cancer caused by HPV types 16, 18, 31, 33, 45, 52, and 58.

• #2 Anal Cancer Prevention (PDQ®): Prevention – Patient Information [NCI] | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.anal-cancer-prevention-pdq%C2%AE-prevention-patient-information-nci.ncicdr0000755491

  Avoiding risk factors and increasing protective factors may help prevent cancer. […] Avoiding cancer risk factors may help prevent certain cancers. Risk factors include smoking, having overweight, and not getting enough exercise. Increasing protective factors such as quitting smoking and exercising may also help prevent some cancers. Talk to your doctor or other health care professional about how you might lower your risk of cancer. […] The following are risk factors for anal cancer: Anal HPV infection. Being infected with human papillomavirus (HPV) is the main risk factor for anal cancer. Being infected with HPV can lead to squamous cell carcinoma of the anus, which is the most common type of anal cancer. About nine out of every ten cases of anal cancer are found in patients with anal HPV infection.

• #2 Anal cancer – HIV Management Guidelines

  https://hiv.guidelines.org.au/management/human-papillomavirus-infection-and-associated-malignancies-in-hiv-infected-people/anal-cancer/

  Squamous cell carcinoma is the commonest (85%) form of anal cancer and is primarily caused by HPV infection (46-49). Additional risk factors are receptive anal intercourse (before the age of 30) (49-51), higher lifetime number of sexual partners (50, 51), current cigarette smoking (48, 52, 53), genital warts (50, 53), and immunosuppression (HIV, post-organ transplantation) (49, 54-56). Anal fistulae and epithelial trauma may also be associated, possibly because they increase access of HPV to the basement membrane (57-59). […] Screening There are no consistent guidelines on how to screen for anal cancer or pre-cancerous lesions. If available, anal cytology with or without high resolution anoscopy has been recommended to detect anal cancer precursor lesions (analogous to cervical cancer) (65). There is ongoing research (including a large randomized controlled trial in the United States) to determine the effectiveness of this screening modality.

• #2 Anal Cancer Prevention (PDQ®): Prevention – Health Professional Information [NCI] | Cigna

  https://www.cigna.com/knowledge-center/hw/medical-topics/anal-cancer-prevention-ncicdr0000755833

  Human papillomavirus (HPV) infection is the strongest risk factor for anal cancer and is accepted as a causal agent of squamous cell carcinoma of the anus and its precursor lesions. […] Based on solid evidence, HPV vaccination of men aged 16 to 26 years who have sex with men in the year before vaccination reduces anal intraepithelial neoplasia (AIN), a precursor lesion of anal cancer. […] Based on solid evidence, treating anal HSIL prevents anal cancer in HIV-positive individuals older than 35 years. When compared with the active monitoring arm, active HSIL treatment was associated with a decreased progression to anal cancer incidence by 57%. […] Because human papillomavirus (HPV) is a causal condition for squamous cell anal cancer development, vaccination against the oncogenic strains of HPV before exposure may reduce the risk of anal cancer. […] Data strongly suggest that vaccination against oncogenic HPV strains will lead to reductions in anal cancer. They also suggest that vaccination before exposure will provide the most benefit.

• #2 What is the HPV Vaccine? | The Anal Cancer Foundation

  https://www.analcancerfoundation.org/what-is-anal-cancer/hpv-vaccine/

  Prevention of anal cancer and precancer in males and females caused by HPV types 16, 18, 31, 33, 45, 52, and 58. […] In both the US and UK, Gardasil is indicated for the following: […] Prevention of anal cancer and precancer in males and females caused by HPV types 16 and 18. […] A study showing Gardasil is effective in preventing HPV-associated anal disease in men was presented before the FDA’s Vaccine and Biological Advisory Committee on November 17, 2010. […] The FDA approved Gardasil for both men and women for the prevention of anal precancer and cancer on December 22, 2010. […] The Foundation also led a coalition of organizations to present three more testimonies in 2011 to encourage the CDC to protect males against HPV by making the HPV vaccination for males as much a part of their routine vaccination schedule as it was for females.

• #2

  https://winshipcancer.emory.edu/cancer-types-and-treatments/anal-cancer/prevention.php

  Most anal cancers stem from human papillomavirus infection, which means the key to anal cancer prevention may lie largely in HPV vaccination. […] As such, researchers believe the key to anal cancer prevention may lie in HPV vaccination and other risk factor reduction. […] Most anal cancers can be avoided by adhering to the following anal cancer prevention guidelines from the American Cancer Society: […] Get vaccinated against HPV. The vaccine is recommended for males and females ages 9 to 45. The vaccine does not treat existing HPV infection; it can only prevent one from occurring. Thats why its important to get children vaccinated prior to initiation of sexual activity. […] Not smoking. […] Managing HIV with strict medication adherence. […] Using condoms with all sexual activity in individuals with multiple sexual partners.

• #2 Prophylactic HPV vaccination and anal cancer

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4964669/

  The incidence of anal cancer is increasing. High risk populations include HIV-positive men who have sex with men (MSM), HIV-negative MSM, HIV-positive women and heterosexual men and women with a history of cervical cancer. HPV has been detected in over 90% of anal cancers. The quadrivalent HPV (qHPV) vaccine has been demonstrated to prevent vaccine associated persistent anal HPV infections as well as anal intraepithelial neoplasia grades 2-3 (AIN2+) in young MSM not previously infected. […] The 9-valent HPV vaccine, when administered to boys and girls prior to the onset of sexual activity, should effectively prevent anal cancer. […] In summary, administering the 9-valent HPV vaccine to girls and boys prior to the onset of sexual activity could effectively prevent almost all anal cancers (primary prevention of SCCA). In addition, the 9v HPV vaccine may be helpful in preventing recurrent AIN2+ and possibly the progression to SCCA, especially in individuals at increased risk for SCCA including all HIV-positive men and women, HIV-negative MSM, and women with history of CIN3 or cervical cancer.

• #2 Screening and Removal of Precancerous Lesions Prevents Anal Cancer | UC San Francisco

  https://www.ucsf.edu/news/2022/06/423126/screening-and-removal-precancerous-lesions-prevents-anal-cancer

  In a groundbreaking finding, a new study led by UC San Francisco found that routine screening for and removal of precancerous anal lesions can significantly reduce the risk of anal cancer, similar to the way cervical cancer is prevented in women. […] This is the first randomized controlled trial showing that treatment of anal precursor lesions is effective in reducing progression to anal cancer, with progression approximately 60 percent lower in the treatment arm. […] Anal cancer is among a limited number of cancers that are potentially preventable through treatment of known cancer precursors, said lead author Joel M. Palefsky, MD, a professor of medicine in the Department of Infectious Diseases at UCSF. […] Given the similarities between cervical cancer and anal cancer, Palefsky and others have adapted these methods to identify anal HSIL and treat the anal lesions to prevent anal cancer.

• #2 Update to the Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV | NIH

  https://clinicalinfo.hiv.gov/en/news/update-guidelines-prevention-and-treatment-opportunistic-infections-adults-and-adolescents-0

  The Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV have been updated. These updates include new recommendations related to anal cancer screening and treatment. […] New screening and treatment recommendations have been developed for the prevention of anal cancer in people with HIV […] Recommendations include a screening program that uses high resolution anoscopy (HRA) to help detect and treat precancer and prevent anal cancer for people with HIV.

• #2 Panel Issues First Guidelines to Prevent Anal Cancer in People With HIV | UC San Francisco

  https://www.ucsf.edu/news/2024/07/428076/panel-issues-first-guidelines-prevent-anal-cancer-people-hiv

  If the screening test is positive, the next step of the evaluation is HRA. If an anal cancer precursor lesion is found at HRA, it is then treated to reduce the risk of progressing to cancer. […] If HRA is not available, people with HIV who are of screening age should still have an annual rectal exam and be referred for standard anoscopy if the screen is positive. Those who have pain, bleeding or masses, or who show signs of anal cancer should undergo standard anoscopy. […] I strongly encourage people with HIV to discuss anal cancer screening with their primary care providers, he said.

• #2 Homepage | The Anchor Study

  https://anchorstudy.org/

  ANCHOR Study Showed that Treatment Can Prevent Anal Cancer! […] Treating anal cancer precursor lesions reduces cancer risk for people living with HIV. […] the Centers for Disease Control now recommends that people with HIV be screened for anal cancer. […] These new recommendations for screening and treatment are based on the results of the ANCHOR Study.

• #2 Anal Cancer Prevention | NY | Montefiore Einstein Comprehensive Cancer Center

  https://montefioreeinstein.org/cancer/types/gastrointestinal/anal-prevention

  The following are risk factors for anal cancer: Anal HPV infection, Certain medical conditions (History of cervical, vaginal, or vulvar cancer, HIV infection/AIDS, Immunosuppression), Certain sexual practices, Cigarette smoking. […] The following protective factors decrease the risk of anal cancer: HPV vaccination, Screening for anal cancer using anoscopy, Treatment of anal lesions. […] Studies show that being vaccinated against HPV lowers the risk of anal cancer. The vaccine may work best when it is given before a person is exposed to HPV. […] Studies suggest that using anoscopy to screen for anal cancer could reduce the number of deaths from the disease in people who are HIV positive. […] Studies show that treatment of anal high-grade squamous intraepithelial lesions (HSIL) decreases the development of anal cancer in people who are HIV positive. […] Cancer prevention clinical trials are used to study ways to prevent cancer. New ways to prevent anal cancer are being studied in clinical trials.

• #2 Anal Cancer Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/2500052-treatment

  In HIV-positive men who have sex with men (MSM), screening for anal cancer has been proposed as a cost-effective measure. […] The use of topical creams in the setting of close long-term follow-up is considered appropriate for AIN lesions. Topical 5% imiquimod cream is considered appropriate for anal margin AIN lesions, as is 5% 5-fluorouracil (5-FU) cream. […] Topical therapy may be especially useful in HIV-positive patients, who have a higher rate of conversion from AIN to cancer. The ANCHOR trial demonstrated a 57% reduced rate of progression to anal cancer in HIV-positive individuals with high-grade squamous intra-epithelial lesions (HSIL) receiving treatment versus active monitoring. […] Targeted biopsy and destruction of the lesions, when visible, are considered the preferred methods of control for AIN.

• #2 Can Anal Cancer Be Prevented? | Preventing Anal Cancer | American Cancer Society

  https://www.cancer.org/cancer/types/anal-cancer/causes-risks-prevention/prevention.html

  HPV vaccines […] Vaccines are available that protect against certain HPV infections. They protect against infection with HPV subtypes 16 and 18. Some can also protect against infections with other HPV subtypes, including some types that cause anal and genital warts. […] Not smoking […] Smoking is a known risk factor for anal cancer. Stopping smoking greatly reduces the risk of developing anal cancer and many other cancers. […] Treating HIV […] For people infected with HIV, its very important to take medicines (known as highly active antiretroviral therapy, or HAART) to help keep the HIV infection under control and prevent it from progressing to AIDS. This can also lower the risk of long-term HPV infection and anal intraepithelial neoplasia (a kind of anal pre-cancer), which might help lower the risk of anal cancer.

• #2 Anal Cancer Risk Factors & Prevention | The Anal Cancer Foundation

  https://www.analcancerfoundation.org/what-is-anal-cancer/prevention/

  The following anal cancer prevention information is provided to help you understand the risk factors and learn about the preventative measures you can undertake to reduce your chances of getting anal cancer. […] Vaccines exist to protect individuals from the most cancer-causing strains of the virus. HPV is the cause of anal cancer 93% of the time. It also causes at least five other cancers, including cervical cancer. Since it is likely most people will have at least one intimate partner during their lifetime, HPV vaccination, screening and practising safe sex are important steps that will help reduce the chance of getting HPV and anal cancer. […] To decrease the risk of transmitting HPV it is important to practise safe sex and use a condom. […] For individuals with HIV, maintaining antiretroviral therapy will help keep the immune system strong.

• #2 Anal Cancer Prevention (PDQ®) – NCI

  https://www.cancer.gov/types/anal/hp/anal-prevention-pdq

  Data strongly suggest that vaccination against oncogenic HPV strains will lead to reductions in anal cancer. They also suggest that vaccination before exposure will provide the most benefit. […] In a study of HPV transmission, MSM, recently had anal sex, and never use condoms were more likely to be infected with oncogenic HPV strains than were those who always used condoms. However, the association was not statistically significant.

• #2 Anal Cancer Prevention – NCI

  https://www.cancer.gov/types/anal/patient/anal-prevention-pdq

  Studies show that treatment of anal high-grade squamous intraepithelial lesions (HSIL) decreases the development of anal cancer in people who are HIV positive. […] It is not known if the use of condoms protects against anal HPV infection. […] Cancer prevention clinical trials are used to study ways to prevent cancer. […] New ways to prevent anal cancer are being studied in clinical trials.

• #2 IPVS-IANS Webinar – Strategies for Anal Cancer Prevention: An Update – IPVS

  http://ipvsoc.org/event/ipvs-webinar-2023_anal_hpv-2/

  Join us for an insightful webinar on strategies for anal cancer prevention, covering recent epidemiological data and its impact on screening recommendations, research gaps in the treatment of anal precancerous lesions, and the role of the HPV vaccine in preventing anal HPV-associated diseases. […] Research gaps on anal precancerous lesion treatment.

• #2 First Federal Guidelines for Anal Cancer Screening Based Partly on Sylvester Data – InventUMPage 1arrow–buttonPage 1arrow–buttonPage 1arrow–buttonPage 1arrow–buttonPage 1arrow–button

  https://news.med.miami.edu/sylvester-contributes-to-anal-cancer-screening-guidelines/

  U.S. health officials recently released guidelines for anal cancer screening for people with HIV, a high-risk group. […] The guidelines are based on results from a landmark study conducted partly at Sylvester Comprehensive Cancer Center, part of the University of Miami Miller School of Medicine, and Jackson Memorial Hospital, a tertiary care center. […] „This really validates what we have been doing and changes the landscape for anal cancer prevention.” […] The study reinforced the value of screening and treatment for anal HSIL in this high-risk population. […] The new guidelines recommend a stepwise screening process tailored to different patient HIV-positive groups with varying levels of risk. […] Key provisions in the new guidelines include: […] „The study was meant for HIV and the CDC guidelines target the HIV population, but we think other high-risk groups can benefit from screening.” […] The new CDC guidelines could lead to an increase in people getting screened for anal cancer and encourage coverage by insurance companies. […] „Watch and wait is no longer a thing.”

• #2

  https://fascrs.org/patients/diseases-and-conditions/a-z/anal-cancer

  Anal cancer is raremuch less common than cancer of the colon or rectum. […] Prevention and screening of high-risk populations are key parts in decreasing the rates of anal cancer and effectively treating the disease when it occurs. A recent study (ANCHOR) shows that treatment of precancerous lesions in high-risk populations will decrease the risk of anal cancer in the future. […] Although few cancers are totally preventable, avoiding risk factors and getting regular checkups are important. Using condoms may reduce, but not get rid of the risk of HPV infection. HPV vaccines (for those ages 9 to 26) have been shown to not only lower the risk of HPV infection, but also reduce the risk of anal cancer in men and women. People at increased risk should talk to their physicians about getting an anal cancer screening. Early identification and treatment of precancerous areas may help prevent anal cancer. […] These guidelines are based on an increased risk by a factor of ten (10 times more likely to develop anal cancer over the general populations at the listed ages).

• #2 Anal cancer – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/anal-cancer/symptoms-causes/syc-20354140

  Anal cancer happens when cells in the anal canal develop changes in their DNA. […] Most anal cancers are thought to be caused by human papillomavirus, also called HPV. HPV is a common virus that’s passed through sexual contact. […] To reduce your risk of anal cancer: Practice safer sex. Reduce your risk of anal cancer by taking measures to prevent sexually transmitted infections. This may include using a condom every time you have sex and limiting the number of sexual partners you have. […] Consider the HPV vaccine. Receiving a vaccination to prevent HPV infection may reduce your risk of anal cancer and other HPV-related cancers. […] Ask about anal cancer screening. Screening tests can help detect anal cancer and precancerous cells that may one day develop into anal cancer.

• #3 Anal Cancer Prevention – NCI

  https://www.cancer.gov/types/anal/patient/anal-prevention-pdq

  Anal cancer is a disease in which malignant (cancer) cells form in the tissues of the anus. […] Squamous cell carcinoma is the most common type of anal cancer. […] In the United States, the number of new cases of anal cancer has increased in recent years. […] Avoiding risk factors and increasing protective factors may help prevent cancer. […] The following are risk factors for anal cancer: Anal HPV infection, Certain medical conditions, Certain sexual practices, Cigarette smoking. […] The following protective factors decrease the risk of anal cancer: HPV vaccination, Screening for anal cancer using anoscopy, Treatment of anal lesions. […] Studies show that being vaccinated against HPV lowers the risk of anal cancer. […] Studies suggest that using anoscopy to screen for anal cancer could reduce the number of deaths from the disease in people who are HIV positive.

• #3 Anal Cancer Prevention (PDQ®): Prevention – Health Professional Information [NCI] | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.anal-cancer-prevention-pdq%C2%AE-prevention-health-professional-information-nci.ncicdr0000755833

  Human papillomavirus (HPV) infection is the strongest risk factor for anal cancer and is accepted as a causal agent of squamous cell carcinoma of the anus and its precursor lesions. […] Based on solid evidence, HPV vaccination of men aged 16 to 26 years who have sex with men in the year before vaccination reduces anal intraepithelial neoplasia (AIN), a precursor lesion of anal cancer. […] Based on solid evidence, treating anal HSIL prevents anal cancer in HIV-positive individuals older than 35 years. When compared with the active monitoring arm, active HSIL treatment was associated with a decreased progression to anal cancer incidence by 57%. […] Because human papillomavirus (HPV) is a causal condition for squamous cell anal cancer development, vaccination against the oncogenic strains of HPV before exposure may reduce the risk of anal cancer. […] These data strongly suggest that vaccination against oncogenic HPV strains will lead to reductions in anal cancer. They also suggest that vaccination before exposure will provide the most benefit.

• #3 Anal Cancer Prevention (PDQ®): Prevention – Health Professional Information [NCI] | Cigna

  https://www.cigna.com/knowledge-center/hw/medical-topics/anal-cancer-prevention-ncicdr0000755833

  Human papillomavirus (HPV) infection is the strongest risk factor for anal cancer and is accepted as a causal agent of squamous cell carcinoma of the anus and its precursor lesions. […] Based on solid evidence, HPV vaccination of men aged 16 to 26 years who have sex with men in the year before vaccination reduces anal intraepithelial neoplasia (AIN), a precursor lesion of anal cancer. […] Based on solid evidence, treating anal HSIL prevents anal cancer in HIV-positive individuals older than 35 years. When compared with the active monitoring arm, active HSIL treatment was associated with a decreased progression to anal cancer incidence by 57%. […] Because human papillomavirus (HPV) is a causal condition for squamous cell anal cancer development, vaccination against the oncogenic strains of HPV before exposure may reduce the risk of anal cancer. […] Data strongly suggest that vaccination against oncogenic HPV strains will lead to reductions in anal cancer. They also suggest that vaccination before exposure will provide the most benefit.

• #3 Anal Cancer Prevention (PDQ®): Prevention – Patient Information [NCI]

  https://mentalhealth.networkofcare.org/baltimorecounty-md/HealthLibrary/Article?docType=general&articleId=ncicdr0000755491

  Being infected with human papillomavirus (HPV) is the main risk factor for anal cancer. Being infected with HPV can lead to squamous cell carcinoma of the anus, which is the most common type of anal cancer. About nine out of every ten cases of anal cancer are found in patients with anal HPV infection. […] The risk of anal cancer is higher in men who are HIV positive and have sex with men compared with men who are HIV negative and have sex with men. Women who are HIV positive also have an increased risk of anal cancer compared with women who are HIV negative. […] Studies show that cigarette smoking increases the risk of anal cancer. Studies also show that current smokers have a higher risk of anal cancer than smokers who have quit or people who have never smoked. […] The following protective factors decrease the risk of anal cancer:

• #3 Anal Cancer Prevention | NY | Montefiore Einstein Comprehensive Cancer Center

  https://montefioreeinstein.org/cancer/types/gastrointestinal/anal-prevention

  The following are risk factors for anal cancer: Anal HPV infection, Certain medical conditions (History of cervical, vaginal, or vulvar cancer, HIV infection/AIDS, Immunosuppression), Certain sexual practices, Cigarette smoking. […] The following protective factors decrease the risk of anal cancer: HPV vaccination, Screening for anal cancer using anoscopy, Treatment of anal lesions. […] Studies show that being vaccinated against HPV lowers the risk of anal cancer. The vaccine may work best when it is given before a person is exposed to HPV. […] Studies suggest that using anoscopy to screen for anal cancer could reduce the number of deaths from the disease in people who are HIV positive. […] Studies show that treatment of anal high-grade squamous intraepithelial lesions (HSIL) decreases the development of anal cancer in people who are HIV positive. […] Cancer prevention clinical trials are used to study ways to prevent cancer. New ways to prevent anal cancer are being studied in clinical trials.

• #3 Anal cancer prevention program at Roswell Park | Roswell Park Comprehensive Cancer Center – Buffalo, NY

  https://www.roswellpark.org/cancertalk/202203/anal-cancer-prevention-program-roswell-park

  Anal cancer screening also can detect abnormal cells and precancerous lesions before they develop into cancer. Prompt treatment can stop the growth of abnormal cells and prevent anal cancer. […] Because the disease poses only minimal symptoms, if any, in early stages, experts recommend that people most at risk receive regular screenings in order to detect and treat abnormal cells or lesions before they become cancerous. The recommendation for those in higher risk groups is to get an anal pap, which is similar to a cervical pap smear, explains Rein. Depending on your risk levels, this screening should be performed every year. […] We can utilize several different treatment options based on each patients circumstances to ultimately prevent those cells from progressing into anal cancer. […] If its caught early, it can really prevent the cancer from spreading and make treatment much easier, he says.

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