Preventing cancer down under: pathology’s role in screening and prevention of anal cancer

Anal cancer, whilst rare in the general population, is rising in incidence. Risk is highest in people living with HIV, solid organ transplant recipients, and survivors of vulval cancer, and in these populations incidence is comparable to bowel, breast and prostate cancers. Almost all cases are driven by infection with human papillomavirus (HPV) and, as most cases are in older persons, the protective impact of HPV vaccination will not be seen for some decades. In March 2025, Australia’s first guidelines for targeted screening to prevent anal cancer were released by the Australian Society for HIV Medicine (ASHM).