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Anal cancer is a relatively common malignancy among HIV-infected adults, particularly men who have sex with men (MSM). Many clinicians have started screening this population for high-grade anal intraepithelial neoplasia (HGAIN), which can be treated and removed before it progresses to invasive anal cancer. To determine the most cost-effective approach to such screening, researchers constructed a decision analysis model using data from a cohort of 400 HIV-infected MSM in Toronto who underwent anal cytological testing, anal high-risk human papillomavirus (HPV) testing, and high-resolution anoscopy (HRA).
Eighteen different strategies, categorized as follows, were evaluated for initial screening: usual care (no screening), direct use of HRA wit…