New Strategies to Assess Anal Cancer Risk In Women
New Strategies to Assess Anal Cancer Risk In Women
The purpose of this research is to study different strategies to identify women at highest
 risk for anal cancer. Primarily, investigators want to study a risk assessment called the
 Anal Cancer Risk Index; it gives women an overall number score based on risk factors that
 they may have for anal cancer, such as age, number of sexual partners, or smoking.
 Investigators seek to understand whether women with higher Anal Cancer Risk Index scores are
 more likely to have abnormal results on anal pap smears, HPV tests, or anal biopsies. The
 study team will collect swabs of the cervix and the anus to study different laboratory tests
 that could identify women at highest risk of cervical and anal cancer. These laboratory tests
 include an anal pap smear, tests for markers of disease and tests that detect the HPV types
 most likely to cause cancer. The study team would like to see which of these laboratory tests
 do the best job at predicting precancerous lesions in the anus and are better indicators of
 risk for cancer. After collecting these swabs, women will have a procedure called high
 resolution anoscopy where investigators look closely at the anus and biopsy any suspicious
 areas. Finally, the study team will look for HPV proteins and changes that HPV can make in
 cells to see if these tests predict anal lesions.
Investigators seek to study different strategies to identify women at highest risk for anal
 cancer. Primarily, investigators want to study a risk assessment called the Anal Cancer Risk
 Index; it gives women an overall number score based on risk factors that they may have for
 anal cancer, such as age, number of sexual partners, or smoking. The study team would like to
 determine whether women with higher Anal Cancer Risk Index scores are more likely to have
 abnormal results on anal pap smears, HPV tests, or anal biopsies. Next, the team will collect
 a swab of the cervix and swabs of the anus to study different laboratory tests that could
 identify women at highest risk of anal cancer: these tests include an anal pap smear and
 tests that detect HPV types most likely to cause cancer. Investigators would like to see
 which of these laboratory tests do the best job at predicting precancerous lesions in the
 anus. After collecting these swabs, women will have a procedure called high resolution
 anoscopy where investigators will look closely at the anus and biopsy any suspicious areas.
 Finally, the study team will look for HPV proteins and changes that HPV can make in cells to
 see if these tests predict anal lesions. The HPV protein is called E6 and E7 and the cell
 change test is called CADM1/MAL/miR-124-2. Investigators will measure E6/E7 and
 CADM1/MAL/miR-124-2 in cervical and anal samples to see if women positive for this marker are
 more likely to have abnormal results on anal pap smears or anal biopsies.
Inclusion Criteria:

 -  Currently enrolled in the Women's HIV Interagency Study (WIHS) study

 -  Able and willing to undergo anal cytology, anal molecular testing, and high resolution
 anoscopy with targeted anal biopsies

 Exclusion Criteria:

 -  History of high grade anal intraepithelial neoplasia (AIN 2 or 3)

 -  History of active anal disease requiring surgery

 -  History of anal or cervical cancer