Thousands of lives could be saved by new anal cancer test
A new test that will detect the early signs of a cancer that is prevalent among gay men has been devised.
The incidence of anal cancer is estimated as 37 per 100,000 in gay men. For gay men who are HIV-positive, the incidence is about twice as great – around 75 per 100,000.
The test, developed after a study, funded by the UK’s Medical Research Council (MRC) and Cancer Research UK, means fewer people would have to undergo radiotherapy and chemotherapy treatment.
Gay campaigner Peter Tatchell, who in 2003 successfully lobbied the UK government to take action on anal cancer, said:
“For gay and bisexual men who are at risk of anal cancer, these tests are an important medical breakthrough. They will help save lives. With this reliable screening test, signs of anal cancer will be detected earlier, leading to speedier, more effective treatment.”
The research, carried out at the MRC Cancer Cell Unit in Cambridge, explores using minichromosome maintenance proteins (MCMs) to detect pre-cancerous and cancerous cells in the anus.
The study, funded by the Medical Research Council and Cancer Research UK, was published in the American journal Cancer Epidemiology Biomarkers and Prevention.
MCMs have been used to find pre-cancerous and cancerous cells in other areas of the body more accurately and effectively but this is the first time they have been used to detect anal cancer.
“This is a much better overall performance than existing methods of detecting anal disease, which either miss too many cases or show up as positive when no disease is actually there.
“MCM tests can also be read by a computer, which would avoid the risk of human error and be a cheaper option too,” lead author of the study, Dr Nick Coleman said.
“Anal cancer is a difficult disease to detect and many cases are identified after it becomes too late for people to undergo simple surgery to remove it.
“We wanted to create a test which was easier to perform and had a high rate of accuracy. This study suggests that MCM testing fits the bill very well indeed.”
Mr Tatchell, who is a parliamentary candidate for the Green party, said:
“This new screening test is likely to save thousands of lives by ensuring earlier diagnosis and treatment. The Cambridge medical team have done magnificent, life-saving work. I offer them my congratulations and appreciation.
“Two decades ago, I deduced that if the Human Papilloma Virus (HPV) causes cervical cancer in women, it must also have the potential to cause anal cancer in people who have anal sex, especially gay and
bisexual men.
“I lobbied the UK government for two decades to take action but was constantly rebuffed. The British Medical Journal and The Lancet declined to report the issue and Cancer Research UK dismissed it.
“Everyone said there wasn’t enough credible research to justify action.
“An evaluation project was established in 2003 by Dr Muir Gray of the NSC. Following a seminar of experts at the British Medical Association headquarters, two working groups were formed to examine future research avenues, the viability of screening programmes and the development of new experimental therapies.
“This has resulted in the coordination and cross-referencing of anal cancer research and treatment throughout the UK, including new therapies and test methods, such as the new diagnostic method devised
by the Cambridge team,” said Mr Tatchell.
The test successfully identified 84% of the patients with anal pre-cancer, without producing a high rate of false alarms in people without disease.
Dr Lesley Walker, director of cancer information at Cancer Research UK, said: “MCMs are already showing promise as early markers to be used in screening for a number of cancers, so it is encouraging to see
this research progressing.
“We must also continue to raise awareness of the disease, particularly among people in high risk groups such as gay and bisexual men so they can take action if they have symptoms.”
Last year PinkNews.co.uk reported that private clinics in London have been injecting gay men with a vaccine designed to reduce the risk of cervical cancer.
The Gardsil vaccine provides protection from human papillomavirus (HPV) which causes the cancer as well as anal warts and cancer of the penis and anus.
The vaccine was developed by Australian scientists to be given to children of both sexes before they start having sex, and was launched in the UK last year.
The BBC reports that clinics in London have been charging gay men £450 for a three-dose course of Gardsil.
Roger Pebody, treatments manager at sexual health charity Terrence Higgins Trust, said it was unclear if the vaccine would be appropriate for adult gay males.
“It may be of use but we need to see some research first – so far the research has been on women,” he told PinkNews.co.uk
“There is a study going in America now which includes gay men.”
It is likely that many sexually active gay men will already have PVT, so a vaccination would not prevent them contracting it.
Critics say there is therefore no point in immunising sexually active people, but some doctors disagree.
Dr Anne Szarewski, clinical consultant for Cancer Research UK told the BBC:
“Men who have sex with men are at a much higher risk than average of anal cancer and genital warts, particularly if they are HIV-positive.”
The government is vaccinating girls at the age of 12 of 13 to reduce the chance of them developing cervical cancer in later life.
HPV is the most common sexually transmitted virus and two of the four strains of HPV have been linked to cancer.
The vaccine programme has been criticised by Christian groups who claim it will increase sexual activity among young people.
