Loading
Treating anal precancer, mostly by burning it off in the clinic, cut the number of people with HIV who went on to develop anal cancer by more than half compared with watching and waiting. It is the first randomised proof that treating an HPV precancer outside the cervix prevents cancer.
Randomised trial of 4,459 people living with HIV aged 35 or older with biopsy-proven anal high-grade squamous intraepithelial lesions (HSIL), assigned to treatment (office-based electrocautery or infrared coagulation, topical fluorouracil or imiquimod, or excision) or to active monitoring with high-resolution anoscopy every six months.
The trial was stopped early for efficacy: 9 participants in the treatment arm and 21 in the monitoring arm progressed to anal cancer, a rate of 173 against 402 per 100,000 person-years, a 57 percent reduction. The result made screening and treatment of anal HSIL a recommendation for people living with HIV.
People living with HIV who have anal HSIL should be offered treatment rather than observation, and screening programmes to find those lesions are now justified. High-resolution anoscopy capacity is the limiting step.
Shares ANCHOR, Anal high-grade squamous intraepithelial lesions (precursor), Anal cancer (squamous cell carcinoma).
Shares Anal cancer (squamous cell carcinoma), Fluorouracil (5-FU).
Shares Anal cancer (squamous cell carcinoma), Fluorouracil (5-FU).
Shares Anal cancer (squamous cell carcinoma), Fluorouracil (5-FU).
Shares Anal high-grade squamous intraepithelial lesions (precursor), Anal cancer (squamous cell carcinoma), Fluorouracil (5-FU).
Shares Fluorouracil (5-FU), New England Journal of Medicine.
Shares Fluorouracil (5-FU), New England Journal of Medicine.
Shares Anal high-grade squamous intraepithelial lesions (precursor), Anal cancer (squamous cell carcinoma).