Similarly to cervical cancer, anal cancer is associated with HPV, though due to more limited data the exact percent caused by HPV and the most involved types of HPV have yet to be confirmed (1). It occurs at a higher rate amongst at-risk populations such as those engaged in receptive anal intercourse. As for cervical cancer, classification of premalignant lesions into anal intraepithelial neoplasia grades (AIN1-3) depends on the extent of dysplasia and evidence for neoplasia. The sensitivity for anal cytology for the detection of premalignant and malignant lesions is only around 70% in a high risk population, comparable to that for cervical cancer (2). However, unlike cervical cancer, carcinogenic HPV testing as a screening tool may not be effective for several reasons: high prevalence of high risk HPV in at risk populations, more limited number of HPV types involved, and cross-reactivity of HPV testing with noncarcinogenic HPV types. Thus for anal cancer in high risk populations, an effective screening program has yet to be defined to guide clinical practice. Currently, clinicians perform anoscopy or high-resolution anoscopy (HRA) as additional work-up, which in comparison to colposcopy may only be about 70% sensitive for the detection of premalignant lesions.
CGI has designed and developed the FISH-based HPV-Associated Cancer Test (FHACTÂ®) that assesses biomarkers commonly detected in HPV-associated cancers and that are observed with higher frequencies in lesions with increasing severity. FHACTÂ® has been optimized to perform on FFPE (formalin-fixed paraffin embedded tissue) specimens.
1. Daling JR, Madeleine MM, Johnson LG, et al. Human papillomavirus, smoking, and sexual practices in the etiology of anal cancer. Cancer 2004;101(2):270-80.
2. Palefsky JM, Holly EA, Hogeboom CJ, Berry JM, Jay N, Darragh TM. Anal cytology as a screening tool for anal squamous intraepithelial lesions. J Acquir Immune Defic Syndr Hum Retrovirol 1997;14(5):415-22.