Fenway Health has been at the forefront of anal dysplasia screening and care for well over 20 years. Now, we are at a particularly promising moment in this work. Earlier this month, the results of a national clinical trial that highlight the success of using High Resolution Anoscopy (HRA) for treating anal cancer precursor lesions in people living with HIV (PLWH). We are proud to offer these life-saving HRA services at Fenway Health.
The Anal Cancer/HSIL Outcomes Research (ANCHOR) study was a phase 3 randomized clinical trial led by Dr. Joel Palefsky at UCSF, performed at 21 clinical sites across the US that had enrolled 4,446 participants followed over a minimum of five years to assess if treating anal cancer precursors reduced the risk of progression to anal cancer among people living with HIV. NIH was able to stop the ANCHOR study earlier than anticipated after learning that treating anal cancer precursors (such as High Grade Squamous Intraepithelial lesions or HSIL) in PLWH did indeed have a high success rate.
Dr. Palefsky notes that ANCHOR data show for the first time that, like cervical cancer, anal cancer can be prevented even in high-risk populations, such as PLWH, who often have HSIL that can be difficult to treat. Although the study was performed in PLWH, the results suggest that anal cancer prevention could be similarly possible in other groups known to be at increased risk of anal cancer, including women with a history of vulvar or cervical cancer, men who have sex with men who are HIV-negative, and men and women who have immunosuppression for reasons other than HIV infection.
This is very exciting news that we have all been waiting many years to see validated. Our Anal Dysplasia clinic is run by Medical Director of Infectious Disease Dr. Ami Multani, who is fully certified in HRA and the treatment of precancerous lesions by the AIDS Malignancy Consortium. She is joined by Julie Thompson PA-C, who is also certified in HRA, and together they share 16 years of experience in specialized anal dysplasia care.
“This is a huge step forward in cancer screening for PLWH and will hopefully provide the momentum needed to increase program support and insurance coverage so that this service is more widely available to all of the patients for whom it would benefit,” said Dr. Multani.
The Fenway Health Anal Dysplasia clinic sees patients four days a week with a current wait time of approximately 2-3 weeks for an appointment. All PLWH and some others who are HIV negative but at risk for anal dysplasia (women with a history of cervical or vulvar dysplasia, HIV negative MSM, patients with a history of anogenital warts or patients on immunosuppressive therapy) should get anal dysplasia screening with an anal pap smear. Any patient with an abnormal anal pap smear should be referred to the Fenway Health Anal Dysplasia Clinic for further evaluation.
Patients can learn more about HRA services at Fenway or schedule an Anal Dysplasia clinic appointment by calling 857.313.6583. Our staff looks forwarding to coordinating care with you.