Loading
ANCHOR proved for the first time that treating precancerous anal lesions in people with HIV prevents anal cancer: those whose lesions were removed or ablated were 57 percent less likely to develop cancer than those who were simply monitored, which is the evidence behind screening and treating these lesions.
ANCHOR was a phase 3 trial of the AIDS Malignancy Consortium that screened more than 10,000 people living with HIV and randomised 4,459 with biopsy-proven anal high-grade squamous intraepithelial lesions to treatment or active monitoring. Treatment was mostly office-based infrared coagulation, hyfrecation or laser ablation, with topical fluorouracil or imiquimod or surgical excision as alternatives; monitoring was high-resolution anoscopy every six months with biopsy of suspected cancer. The primary endpoint was time to progression to anal cancer.
The monitoring committee stopped the trial early for efficacy. At a median follow-up of 25.8 months, nine cancers were diagnosed in the treatment group (173 per 100,000 person-years) and 21 in the monitoring group (402 per 100,000 person-years), a 57 percent reduction. The result led the United States guidelines to recommend anal cancer screening and treatment of high-grade lesions in people with HIV, which is how the corpus's anal cancer precursor page cites it.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
4,446 analysed.
9 cases; 95% CI 90 to 332; median follow-up 25.8 months · 21 cases; 95% CI 262 to 616
Source95% CI 6 to 80
Source| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Incidence of anal cancerprimary | Treatment of high-grade lesions | - | 173 cases per 100,000 person-years | - | 0.03 | link |
| Active monitoring | - | 402 cases per 100,000 person-years | ||||
| Reduction in the rate of progression to anal cancer with treatment | Treatment against active monitoring | - | 57% | - | - | link |
Shares Anal cancer (squamous cell carcinoma), Fluorouracil (5-FU) and the tag soc-trials.
Shares Anal cancer (squamous cell carcinoma) and the tag soc-trials.
Shares Anal cancer (squamous cell carcinoma) and the tag soc-trials.
Shares Active surveillance and the tag soc-trials.
Shares Active surveillance and the tag soc-trials.
Shares Fluorouracil (5-FU) and the tag soc-trials.
Shares Fluorouracil (5-FU) and the tag soc-trials.
Shares Fluorouracil (5-FU) and the tag soc-trials.