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Sylvester Plays Pivotal Role In Practice-Changing Anal Cancer Prevention Study Published By Nejm

Transforming Patient Care

ANCHOR study is likely to establish a new standard of care for people living with HIV.

Isabella Rosa Cunha, M.D.

Findings from the ANCHOR study that has screened 10,723 people living with HIV (PLHIV) and enrolled 4,446 from 25 U.S. sites, including Sylvester and Jackson Memorial Hospital, show that treating anal high-grade squamous intraepithelial lesions (HSIL), which are potentially precancerous, significantly lowers the risk of anal cancer compared to taking a wait-and-see approach.

The risk of anal cancer is higher among PLHIV than in the general population. And anal cancer is biologically similar to cervical cancer in the sense that both are caused by HPV and preceded by HSIL, according to Isabella Rosa Cunha, M.D., principal investigator of the ANCHOR study sites at Sylvester and Jackson Memorial Hospital and associate professor of medicine at the Miller School.

Investigators studied PLHIV 35 years and older with biopsies showing that they had anal HSIL. Subjects were randomized to either a treatment group, in which their lesions were treated mainly with electrocauterization, or an active monitoring group, without treatment.

During the study, nine cases of anal cancer were diagnosed among the 2,227 treated participants, compared with 21 cases of cancer among the 2,219 participants in the active monitoring group. The incidence of anal cancer was about 60% lower in the treatment arm, which is a significant finding.

This study will likely improve anal cancer prevention in other high-risk groups, including HIV-negative men who have sex with men, transplant patients, and women with HPV vulvar disease, according to Dr. Rosa-Cunha. The National Cancer Institute, which funded the study, has approved the study to continue to follow these patients until 2025.