HIV treatment centres should screen and treat pre-cancerous anal lesions, UK investigators argue in the online edition of AIDS. They were prompted to make this suggestion by research showing that treatment with imiquimod cream resolved or downgraded high-grade pre-cancerous anal lesions in 61% of HIV-positive gay men.
Although the investigators do not claim that imiquimod will prevent anal cancer, “we at least know that high grade anal intraepithelial neoplasia [HG-AIN, pre-cancerous lesions] can be cured. This is certainly not going to prevent all anal cancers, but it would be a grave error to await the outcome of long-term natural history studies…the time has come for all HIV centres to begin screening for and treating AIN.”
Rates of anal cancer are increasing in patients with HIV. Before the cancer develops pre-cancerous lesions develop in the anal canal.