Dear Friend,
In a groundbreaking move towards global standardization in anal cancer screening, the International Anal Neoplasia Society (IANS) has released long-awaited comprehensive screening guidelines. Throughout the year, ACF actively participated on IANS’ screening guidelines committee, contributing to a pivotal moment in the journey to establish an international standard for anal cancer screening across diverse populations and countries.
Anal cancer screening has long lacked a unified global approach, with only one U.S. state currently having a standard recommendation. Recognizing the urgent need for a cohesive strategy, IANS emerged as the first medical society dedicated to creating an international standard.
These guidelines now offer evidence-based consensus guidance on which populations should undergo anal cancer screening and how abnormal screening results should be managed. The recommendations take into account the existing screening tools and set the stage for expanding anal cancer screening infrastructure to at-risk populations.
A major focus of these guidelines is on populations with a significantly higher anal cancer incidence, specifically those with a greater than 10-fold increase compared to the general population. This Risk Category A group includes individuals who are living with HIV, individuals with a history of vulvar precancer or cancer, solid organ transplant recipients, men who have sex with men, and transgender women.
Additionally, the guidelines extend to populations with increased anal cancer incidence, albeit less than a 10-fold increase, categorized as Risk Category B. This group encompasses individuals such as women with a history of cervical or vaginal precancer or cancer as well as patients with autoimmune diseases. For Risk Category B populations, the guidelines recommend a shared decision-making approach, recognizing their relatively lower risk while emphasizing the importance of adequate access to high-resolution anoscopy (HRA).
The release of these guidelines marks a crucial step towards a standardized and inclusive approach to anal cancer screening. They bring us closer to our goal of ending anal cancer by identifying cases in the precancerous stage and providing targeted guidance for people who may be at risk. A group of experts led by IANS will be working to ensure that providers across the country are educated about these recommendations. We are grateful to the hard work of many doctors and researchers that led to this moment. We especially want to thank Beth Stier and Naomi Jay for leading the effort.
However, there is still work to do. Medical society recommendations do not reach all providers and populations, so we must work to make them national recommendations, supported by health agencies and additional healthcare organizations. The IANS screening recommendation is the first and critical step of multiple toward national anal cancer screening guidelines. In addition, we need to advocate for more research to understand the biomarkers that lead to disease progression among at-risk populations and those who appear to have no risk factors and yet are diagnosed with anal cancer.
Thank you for all your support as we work to end deaths and diagnoses from anal cancer. We could not do this work without you.
With Gratitude,
Justine Almada
Executive Director
