Advancing Anal Cancer Prevention in High-Risk Populations: An Interdisciplinary, Register-Based Approach to Screening and Biomarker Discovery

Anal cancer incidence is rising globally.

The International Anal Neoplasia Society recommends screening high-risk individuals using high-resolution anoscopy (HRA).

However, most countries lack anal cancer screening guidelines, and HRA´s limited availability necessitates more efficient risk stratification methods.

This project aims to advance anal cancer prevention through comprehensive register-based research and innovative biomarker discovery, with a particular focus on women, an understudied population in anal cancer research.

Our objectives are to; I) quantify Sweden´s anal cancer burden, stratifying by immune status to identify risk groups, II) evaluate the feasibility, cost-effectiveness, and acceptability of implementing international anal cancer screening guidelines for women with HIV, III) investigate DNA methylation markers´ predictive potential for precancerous anal lesion progression, and IV) assess circulating HPV DNA in plasma as a pre-diagnostic biomarker for anal cancer.

We will utilize national registers and international collaborations through; I) a nationwide register-based cohort study of anal cancer burden, II) a prospective register-based study of anal cancer screening in women with HIV, III) analysis of DNA methylation markers in anal samples, and IV) an international register-based nested case-control study of circulating HPV DNA.

This project will generate crucial knowledge to inform evidence-based anal cancer prevention policies for high-risk groups.