Screening for anal cancer in PLWHIV: a call for action

Monday 15 September 3:00pm - 5:00pm

People living with HIV are at greatly increased risk of anal cancer. Incidence rates have remained high, even in people with well-controlled immune deficiency receiving long-term anti-retroviral therapy. A large pivotal randomised trial in PLWHIV recently showed that diagnosing and treating high-grade lesions decreased risk cancer risk by 57%. In response, in 2024, the United States Department of Health and Human services guidelines for treating opportunistic infection in PLWHIV added a recommendation for screening using anal cytology and/or anal human papillomavirus infection. Also in 2024, the Royal Australian College of Pathologists submitted a Medical Services Advisory Committee application for the diagnostic and therapeutic procedures. Early in 2025, ASHM released Australian guidelines for anal cancer screening in PLWHIV using an algorithm based on anal high-risk HPV testing and triage testing using anal cytology.