By Jeffrey Norris, UCSF Science Cafe | January 13, 2010
By Elizabeth Fernandez | UCSF.edu | November 22, 2013
A UC San Francisco investigator has won an eight-year grant from the National Cancer Institute for a major investigation into anal cancer, a debilitating and sometimes fatal disease largely concentrated among people with HIV.
The total amount of the award over the life of the grant is projected to be approximately $89 million.
Anal cancer disproportionately affects HIV-infected men and women, but the rate of infection is rising among people who do not have HIV and without active intervention, and the number of cases is expected to continue to grow in the general population.
Like cervical cancer and some oral cancers, most cases of anal cancer are associated with human papillomavirus (HPV). Vaccination has been shown to reduce the risk, but the majority of HIV-infected individuals currently at risk for anal cancer are older than age 26, do not qualify for vaccination, and may already have been exposed to the form of HPV known to cause anal cancer.
“Given these strong biological similarities, it is very possible that biomarkers and treatments identified in the study will be applicable to cervical and HPV-associated oral cancer as well,” said Joel Palefsky, MD, a UCSF professor of medicine and principal investigator of the anal cancer project.
The study will focus on determining the effectiveness of treating anal high-grade squamous intraepithelial lesions (HSIL), which are caused by chronic HPV infection, in reducing the incidence of anal cancer in HIV-infected men and women.
Combined with the possibility that anal cancer is preventable, the incidence of anal cancer is unacceptably high and calls for urgent intervention, Palefsky said.
“Compared with the general population, the incidence of anal cancer is increased more than 100-fold among some risk groups of HIV-infected persons, including many who are successfully treated with combination antiretroviral therapy,” Palefsky said. “There is evidence that anal HSIL is the precursor to invasive anal cancer, which makes it a great target for prevention.”