Anal cancer is uncommon in the general population, but is one of the most common cancers occurring in people living with HIV. It is associated with human papillomavirus, the same virus that causes cervical cancer. Advances in HIV treatments mean that people with HIV have a similar life expectancy to people without HIV, but people with HIV continue to experience very high rates of anal cancer.

Until now, there has been no proven method of prevention. Results of a large randomised trial authored by Dr Joel Palefsky from the University of California in San Francisco published in today's New England Journal of Medicine demonstrate that treatment of pre-cancerous lesions reduced the rate of anal cancer by 57%.

Treatment involved locally destructive therapies, mainly based on electrocautery administered during an office-based procedure called high-resolution anoscopy (HRA). These treatments are administered by doctors who are highly experienced in HRA.

Our research at the Kirby Institute has documented that about 50% of gay men with HIV have anal cancer precursors. However, Australia currently has few centres where HRA can be performed and the treatments administered. These results showing that anal cancer can be prevented in people living with HIV suggest that Australia needs to rapidly scale up medical facilities for the early detection of anal cancer precursors and the performance of HRA and treatment in people living with HIV.