INTRODUCTION

The information provided in the toolkit is based on the IANS guidelines that provide evidence-based consensus guidance for which populations should be offered anal cancer screening. In addition, we offer management of abnormal screening results, utilizing currently available screening tools.

It is essential to highlight that screening is intended for individuals who are asymptomatic and that the screening program’s goal is to detect and treat anal pre-cancer lesions, anal high grade intraepithelial lesions (HSIL). This depends on access to high resolution anoscopy (HRA). Screening with anal cytology and high risk HPV testing, should only be offered provided there is sufficient capacity for HRA. If your site does not have immediate access to HRA, digital anorectal examination (DARE) can be used as an early anal cancer detection tool.

IANS recognizes that in many regions and countries, scarcity of HRA resources may preclude implementation of these guidelines and there will be a need to develop the necessary infrastructure to provide HRA services. In addition, we hope that longitudinal data regarding harms and benefits of screening will provide the basis for risk-based screening and management recommendations. IANS guidelines serve as a foundation for advocacy and expansion of HRA and screening infrastructure, thereby ensuring that anal cancer prevention becomes accessible to all at-risk populations.

Sincerely,

The IANS Implementation Task Force

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