4 March 2025 – Australia’s first national anal cancer screening guidelines for people living with HIV have been released, providing a critical framework around screening and treatment for healthcare providers.
Globally, people living with HIV have the highest incidence rate of anal squamous cell carcinoma, the most common type of anal cancer. The guidelines, launched by ASHM and the second of their kind in the world, will address a key gap in available resources for clinicians.
Professor Jason Ong, a sexual health physician and ASHM Vice President, said the new guidelines will help build clinicians’ awareness of the warning signs of anal cancer and how to screen for it amongst this priority group.
“Men who have sex with men who are living with HIV have an anal cancer incidence rate over 60 times higher than the general population. Evidence-based screening is essential to close this gap,” said Dr Ong.
“These guidelines equip healthcare providers with the latest recommendations for screening, diagnosis, and management of precursor lesions of anal cancer in people living with HIV—ensuring early intervention and better patient outcomes,” he said. Currently, anal squamous cell cancer is often diagnosed at an advanced stage due to a lack of obvious early-stage symptoms. The guidelines advocate for proactive screening to drive earlier detections and a better prognosis for patients.
The launch of the guidelines coincides with International HPV Awareness Day on 4 March, with nearly 90% of anal cancer cases caused by human papillomavirus (HPV). In Australia, high-risk HPV testing is the primary screening test for anal cancer, with the guidelines also recommending that screening includes physical examinations and a thorough medical history.
“Regular digital anorectal exams and anal cytology or HPV tests can detect abnormalities before they progress to cancer. Following these guidelines means saving lives through early detection,” said Dr Ong.
The Anal Cancer Screening Guidelines for People Living with HIV are available online at www.analcancerscreening.guidelines.org.au.
Key recommendations from the Anal Cancer Screening Guidelines for People Living with HIV
- Gay, bisexual and other men who have sex with men (GBM) and trans women LHIV over 35 years of age should be offered screening
- Cis-women, trans men and other cis-men (not GBM) LHIV over 45 years of age should be offered screening
- The screening modality should be primary HRHPV testing with cytology triage
- Screening should be repeated every 3 years for those who screen negative
- Screening should be discontinued, with shared decision-making, at age 75 years and in individuals with two consecutive negative screening visits who are not currently sexually active
About the Anal Cancer Screening Guidelines for People Living with HIV
The Anal Cancer Screening Guidelines for People Living with HIV are designed for use by clinicians to improve awareness and knowledge around risk factors and screening for anal squamous cell cancer in people living with HIV. The guidelines are Australia’s first and the world’s second guidelines on anal cancer screening for people living with HIV.
The guidelines were developed in collaboration between representatives from community and sector organisations, including: Alfred Health, ASHM, Douglass Hanly Moir Pathology, Melbourne Sexual Health Centre, Monash University, NAPWHA, Positive Life NSW, St Vincent’s Hospital, The Kirby Institute, UNSW Sydney.
Access the Anal Cancer Screening Guidelines for People Living with HIV: https://analcancerscreening.guidelines.org.au/
Download the Media Release
Download this media release as a PDF using the button below.
