INTRODUCTION

Anal cancer prevention begins with screening, with the goal of identifying individuals with anal high-grade squamous intraepithelial lesions (HSIL), the precursor to anal cancer. HSIL is typically diagnosed during evaluation with high-resolution anoscopy (HRA). When HSIL is identified, it can be treated to prevent progression to cancer.

For patients without access to HRA, screening to identify possible anal cancers can be performed using a digital anal rectal examination (DARE), which aims to detect cancers at an earlier and more treatable stage.

This toolkit, developed by the IANS Implementation Task Force, is designed to inform, guide, and support efforts to implement effective anal cancer screening and prevention. The materials may be used by healthcare providers, patient advocates, and patients.

An effective screening program relies on initial screening with anal swab collection (for cytology and/or HPV testing) and DARE. These services can be performed by primary care clinicians, gynecologists, HIV providers, or other specialists who care for at-risk populations. It is important to note that screening for anal HSIL should only be offered when there is adequate access to HRA. In its absence, screening for anal cancer using DARE should be offered universally to at-risk populations.

We hope you find this toolkit helpful, and we invite you to join the mission to prevent anal cancer!

Sincerely,

The IANS Implementation Task Force