Official websites use. Share sensitive information only on official, secure websites. Men who have sex with men MSM who are living with human immunodeficiency virus HIV are at highest risk for anal cancer. Our objective was to use empirical data to develop a comprehensive disease simulation model that reflects the most current understanding of anal carcinogenesis, which is uniquely positioned to evaluate future anal cancer screening strategies as well as provide insight on the unobservable course of the disease.
We synthesized existing evidence into a state-of-the-art anal cancer disease simulation model that will be used to quantify the tradeoffs of harms and benefits of alternative strategies, understand critical uncertainties, and inform national anal cancer prevention policy.
Keywords: Human papillomavirus HPV , anal neoplasms, decision analysis, mathematical model. The average population risk of developing anal cancer is less than 2 per , individuals. However, men who have sex with men MSM living with human immunodeficiency virus HIV face a 30β70 times greater risk of developing anal cancer 1 β 4.
Unlike cervical cancer, standardized national or international screening protocols for squamous cell carcinoma of the anus do not yet exist 5 despite the growing evidence that this human papillomavirus HPV -related cancer is preceded by premalignant stages, which if detected and removed, may prevent progression to cancer 6. Several prospective longitudinal natural history studies among high-risk populations have contributed to advancing the biological understanding of anal HPV and precancers 7 , while ongoing clinical trials seek to evaluate the efficacy of ablative methods infrared coagulator or hyfrecation and topical therapies such as 5-fluorouracil cream to remove anal precursors and prevent progression to anal cancer Clinical trials identifiers: NCT and NCT Computer-based simulation models synthesize and extrapolate currently-available evidence from epidemiologic and clinical studies and can be used to evaluate long-term outcomes such as cancer diagnosis and mortality that are not readily observable in existing studies.
In addition, the development of a comprehensive natural history model that reflects the current understanding of anal carcinogenesis can be used to estimate the value of cancer control interventions e.
