1. Prospective 3 year study on anal HPV in older gay/MSM i.e. 35 years & older; important because this will be a mostly unvaccinated cohort
  2. HPV 16: ~ 50% of all HPV related cancers plus it is the type least likely to be cleared
  3. HSIL (high grade intra-epithelial lesion): found in 30-50% of HIV +ve men
  4. Cochrane review: there is no current evidence that treatment of high grade lesions prevents progression to cancer
  5. Research being done into the potential for anal cancer biomarkers to predict disease persistence




Testing for MSM