Prevalence of anal cancer precursors is higher among women living with HIV than previously reported

The prevalence of high-grade squamous intraepithelial lesions (HSIL), which precede cancer of the anus, is much higher among women living with HIV than previously reported, a national study found multi-site involving hundreds of patients. Led by researchers at the AIDS Malignancy Consortium, a group of clinical trials supported by the National Cancer Institute, the findings call for new strategies to be developed for broader screening of women living with HIV who have cancer rates bad more disproportionate compared to the general population. women. The study appears in Clinical Infectious Diseases.

In the United States, the researchers performed for the first time a full bad evaluation including a high-resolution anoscopy (anus examination under magnification) and a biopsy directed at all patients. 256 participants in the study, not just those who had been screened or had an abnormal triage. The prevalence of bad HSIL was 27%, which is significantly higher than the previous study estimates of between 4% and 9%.

We believe that most previous studies on the prevalence of bad HSIL in women living with HIV underrepresented the true percentage, as only those with abnormal bad cytology had undergone high resolution anoscopy at study. compared to all participants in this new study. "

Dr. Elizabeth Chiao, co-author and principal investigator of the study

Dr. Chiao is a professor of medicine at the Infectious Diseases Section of Baylor College of Medicine and the Houston Innovation Center for Quality, Efficiency, and Safety.

The study was conducted in 12 academic medical centers in the United States. Participants were recruited between 2014 and 2016. The average age of participants was 49.4 years, of which 64% were non-Hispanic blacks and 67% current or former smokers.

"The high prevalence of precursors of bad cancer and invasive bad cancer in women living with HIV calls for more screening in this population," said lead author Elizabeth Stier, MD of the Boston Medical Center, who is also Associate Professor in Obstetrics and Gynecology at Boston University School of Medicine. "Since optimal screening strategies are not yet known, the prevention of bad cancer in this population should focus on identifying cost-effective strategies for the detection and management of precursors of bad cancer."

Screening for anus cancer in women living with HIV has been recommended by national organizations, including the American Cancer Society, the American Society of Infectious Diseases and the American Society of Colon and Pediatric Surgeons. rectum.