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Anal Cancer Awareness, Screening, and Prevention

Postive Life Series | April 1, 2025 The content of this particular "Positive Life" presentation focuses on anal cancer screening and prevention. Anthony Velasco discusses several key aspects of this topic, including: Prevention Strategies: Velasco highlights HPV vaccination as one of the best ways to prevent anal cancer. He also mentions the importance of smoking cessation in reducing the risk and discusses the role of barrier protection during sexual activity in potentially decreasing HPV exposure . Screening Methods: The presentation covers anal cytology (anal Pap smear) and high-resolution anoscopy as screening methods. Velasco explains that a**l cytology may underrepresent the grade of the disease and that combining it with visual inspection during high-resolution anoscopy provides more information. He also clarifies the difference between a general endoscopy and a high-resolution endoscopy, emphasizing the magnification used in the latter for better detection of abnormalities. The ANCHOR Study: He discusses the ANCHOR study, which demonstrated the effectiveness of treating precancerous al lesions to decrease the rate of al cancer in people living with HIV. The findings underscore the importance of identifying and treating these lesions. Treatment Modalities: Various treatment options for precancerous lesions are mentioned, including infrared coagulation, HIFU (High-Intensity Focused Ultrasound), and laser ablation, often performed in-office. Topical agents like imiquimod and TCA (trichloroacetic acid) are also discussed, along with their considerations and limitations. Importance of Early Detection: Velasco repeatedly emphasizes that early prevention and early screening are crucial in managing and reducing the risk of anal cancer. Age of Onset: It's noted that while anal cancer typically occurs later in life in the general population, it can present earlier in individuals living with HIV, sometimes in their early to mid-forties.