Why Screen for Anal Cancer in HIV-Positive Patients?
Anal cancer is emerging as a common non-AIDS defining cancer in HIV-positive people. Anal cancer, like cervical cancer, is caused by infection with high-risk types of human papillomavirus (HPV) — low-risk types of the virus can cause genital and anal warts. The rate of anal cancer appears to be increasing in the era of antiretroviral therapy.1-5 A recent analysis from Kaiser-Permanente in California estimated the rate of anal cancer among the HIV-positive population to be 174/100,000 person-years — and even higher among individuals with lower CD4+ counts — compared to 2/100,000 person-years among the HIV-negative population.6 This rate is significantly higher than the rate of cervical cancer before Papanicolaou (PAP) screenings became routinely performed on women (35/100,000).
