Screening for Anal Cancer in HIV Positive Patients: Should We Make It A Standard-of-care?

Anal cancer is biological similar to cervical cancer, and is preceded by anal intraepithelial neoplasia (AIN). Screening for AIN and treatments to reduce the risk of anal cancer are not established as guidelines of care for HIV-infected patients. It is mainly because screening and treating of AIN is not yet proven to reduce the incidence of anal cancer. The present study preliminarily demonstrated that a successful screening program in preventing squamous cell anal cancer in HIV positive patients. The authors achieved their purpose of controlling the evolution of all abnormalities identified during the anal cancer screening, preventing AIN to progress towards anal cancer, and reversing any form of AIN by surgery, ablation or medical therapy. Randomized controlled multi-center trials with a large sample size should be carried out to validate the study results. It is wise for the physicians to actively screen and treat AIN in HIV-infected patients whenever possible unless the results of randomized controlled study demonstrate that doing so is inappropriate.