Title : Anal squamous cell carcinoma in lancashire and south cumbria: Regional epidemiology and alignment with current screening recommendations
Abstract:
Aim: Anal Squamous cell carcinoma (ASCC) is uncommon but has an increasing incidence. The 2024 International Anal Neoplasia Society (IANS) consensus guidelines for ASCC screening prioritise high-risk groups, primarily individuals with HIV, men who have sex with men (MSM) and transgender women. Our aim was to assess patients newly diagnosed with ASCC in Lancashire and South Cumbria in relation to screening recommendations.
Method: A retrospective study was performed on all new cases of ASCC across a regional cancer network diagnosed between 01.01.2024 – 31.12.2024. Cases were identified from regional MDT records. Demographic and clinical variables were extracted from electronic patient records. Socioeconomic deprivation was assessed using the 2019 Index of Multiple Deprivation (IMD) tool.
Results: During the 12-month period there were 66 new cases of ASCC: 68% were female, the median age was 62.5 years. Chemoradiotherapy was the first line treatment in 67% and 73% were Stage 3 or above. Only 10.6% were HIV-positive MSM, there were no cases of transgender women, and 1.5% had history of other HPV-related malignancy. IMD data showed that 24% lived within IMD decile 1 (top 10% of most deprived neighbourhoods in England) and 48% lived within IMD decile 3.
Conclusions: Although IANS consensus guidelines appropriately target groups with higher incidence of ASCC, the burden of disease in our study lies outside the targeted populations. Implementation of such guidelines would have minimal impact for the vast majority of ASCC in our study group where social deprivation is a clear risk factor.
