Photo Credit: Md Babul Hosen

The following is a summary of “Anal Cancers in Previously Screened Versus Unscreened Patients: Tumor Stage and Treatment Outcomes,” published in the January 2024 issue of Gastroenterology by Walker, et al.

People who are at high risk for anal squamous-cell cancer have been suggested to go through targeted screening programs. However, the proof for these programs is still not clear. For a study, researchers sought to find out if checking high-risk patients (mostly people living with HIV) for squamous-cell cancer found the disease earlier than when screening was not done. It was a group study. People who were at least 18 years old and had invasive anal squamous-cell cancer between 2002 and 2022 were included.

People who were identified through a high-risk screening program were compared to people who were not screened. The main outcome was the clinical stage at appearance, which was categorized as T1N0M0 or other. Treatments received, treatment failure, and total life were examples of secondary outcomes. There were 612 people with anal squamous-cell cancer in the study, and 26 of them were found through a screening program. Patients who had cancers found on a screen were more likely to have T1N0M0 tumors than patients who had not been checked (18 [69.2%] vs 84 [14.3%]; adjusted OR 9.95; 95% CI, 3.95–25.08). The sensitivity analysis results matched by propensity score were the same (OR 11.13; 95% CI, 4.67–26.52). 

People who were screened were more likely to be treated with wide local excision alone than with any mix of chemotherapy, radiation therapy, and surgery (3 [12.5%] vs 18 [3.2%]; OR 4.38; 95% CI, 1.20–16.04). Treatment failure or total mortality did not vary between groups in a statistically significant way. Finding anal squamous-cell carcinoma earlier through screening is helpful for people who are at a high risk of getting it. Patients with cancers found on a screen were also more likely to be able to get wide local excision alone, which may have saved them the pain and suffering that comes with chemoradiotherapy or abdominoperineal removal. 

Source: journals.lww.com/dcrjournal/abstract/2024/01000/anal_cancers_in_previously_screened_versus.7.aspx