Johanna Brännström

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.