Christina Carlander

Anal cancer incidence is rising globally. The International Anal Neoplasia Society recommends screening high-risk individuals using high-resolution anoscopy (HRA). However, most countries lack anal cancer screening guidelines, and HRA's limited availability necessitates more efficient risk stratification methods. This project aims to advance anal cancer prevention through comprehensive register-based research and innovative biomarker discovery, with a particular focus on women, an understudied population in anal cancer research. Our objectives are to

I) quantify Sweden's anal cancer burden, stratifying by immune status to identify risk groups, II) evaluate the feasibility, cost-effectiveness, and acceptability of implementing international anal cancer screening guidelines for women with HIV, III) investigate DNA methylation markers' predictive potential for precancerous anal lesion progression, and IV) assess circulating HPV DNA in plasma as a pre-diagnostic biomarker for anal cancer. We will utilize national registers and international collaborations through

I) a nationwide register-based cohort study of anal cancer burden, II) a prospective register-based study of anal cancer screening in women with HIV, III) analysis of DNA methylation markers in anal samples, and IV) an international register-based nested case-control study of circulating HPV DNA. This project will generate crucial knowledge to inform evidence-based anal cancer prevention policies for high-risk groups.

Despite an increased risk of cancer in people with HIV, the only current HIV specific cancer screening guideline is for cervical-cancer-screening, to which our research-group has earlier contributed. Clearly, there is a need for HIV specific screening guidelines for other cancers

breast, lung, anal, and colon cancer, where an increased risk, earlier debut, or poorer prognosis among people with HIV has been identified. The aim of this project is to firstly develop predictive models for cancer risk in people with HIV, using unsupervised machine learning techniques on datasets based on demographic, socioeconomic, HIV-related, and comorbidity factors. Secondly, we aim to evaluate these prediction models through counterfactual prediction to justify the development of a clinical user-friendly tool to help guide individualized cancer prevention and screening for the population with HIV. To our knowledge this is the first project using machinelearning to create cancer-prediction models in an HIV-population. In summary, our aim is to create a clinical tool "HIVigilant: Cancer Screening Guide”, for individualized cancer prevention and screening of the population with HIV. This clinical tool can be integrated in the HIV register for easy access and use for all HIV clinicians in Sweden. This will save lives and reduce the burden of cancer among people with HIV. The knowledge that this project contributes can also be useful in the work of cancer prevention in the general population.

Despite an increased risk of cancer in people with HIV, the only current HIV specific cancer-screening guideline is for cervical-cancer-screening, to which our research-group has earlier contributed. Clearly, there is a need for HIV specific screening guidelines for other cancers

breast, lung, anal, and colon cancer, where an increased risk, earlier debut, or poorer prognosis among people with HIV has been identified. The aim of this project is to firstly develop predictive models for cancer risk in people with HIV, using unsupervised machine learning techniques on datasets based on demographic, socioeconomic, HIV-related, and comorbidity factors. Secondly, we aim to evaluate these prediction models through counterfactual prediction to justify the development of  a clinical user-friendly tool to help guide individualized cancer prevention and screening for the population with HIV. To our knowledge this is the first project using machine-learning to create cancer-prediction models in an HIV-population. In summary, our aim is to create a clinical tool "HIVigilant: Cancer Screening Guide”, for individualized cancer prevention and screening of the population with HIV. This clinical tool can be integrated in the HIV register for easy access and use for all HIV clinicians in Sweden. This will save lives and reduce the burden of cancer among people with HIV. The knowledge that this project contributes can also be useful in the work of cancer prevention in the general population.

Anal cancer incidence is rising globally. The International Anal Neoplasia Society recommends screening high-risk individuals using high-resolution anoscopy (HRA). However, most countries lack anal cancer screening guidelines, and HRA´s limited availability necessitates more efficient risk stratification methods. This project aims to advance anal cancer prevention through comprehensive register-based research and innovative biomarker discovery, with a particular focus on women, an understudied population in anal cancer research. Our objectives are to

I) quantify Sweden´s anal cancer burden, stratifying by immune status to identify risk groups, II) evaluate the feasibility, cost-effectiveness, and acceptability of implementing international anal cancer screening guidelines for women with HIV, III) investigate DNA methylation markers´ predictive potential for precancerous anal lesion progression, and IV) assess circulating HPV DNA in plasma as a pre-diagnostic biomarker for anal cancer. We will utilize national registers and international collaborations through

I) a nationwide register-based cohort study of anal cancer burden, II) a prospective register-based study of anal cancer screening in women with HIV, III) analysis of DNA methylation markers in anal samples, and IV) an international register-based nested case-control study of circulating HPV DNA. This project will generate crucial knowledge to inform evidence-based anal cancer prevention policies for high-risk groups.