WASHINGTON, DC (June 9, 2017)—A George Washington University (GW) researcher was awarded more than $1.81 million by the National Institutes of Health and the National Cancer Institute to explore several biomarkers that could lead to a better approach for anal cancer screening.
Jeanne A. Jordan Ph.D., professor in the department of epidemiology and biostatistics in the George Washington University’s Milken Institute School of Public Health, believes that combining one or more of these biomarkers with the anal Pap test might improve the current screening approach for anal cancer.
Anal cancer is a growing problem in the United States, especially for men who have sex with men. Such men, especially if they are living with HIV, are also at higher risk of being unable to clear infection with the human papillomavirus (HPV). Certain types of HPV are known to cause anal cancer. An estimated 8,200 people in the United States will develop this type of potentially deadly cancer in 2017.
Currently when a man living with HIV goes to a doctor for screening, he undergoes an anal Pap test, which looks for abnormal changes in cells. In an attempt to improve the chances of identifying someone at high risk for anal cancer, physicians currently will also test for the presence of HPV DNA.
That test is very good at identifying an HPV infection but doesn’t help to predict their risk of anal cancer. Thus the combined anal Pap test plus HPV test in its current form sends too many men on for a biopsy, an invasive test that is used to diagnose anal cancer.
Jordan and her team are going to study some alternate biomarkers that when used along with the anal Pap test might lead to a more effective screening for this kind of cancer. For example, the team will look at the expression of certain HPV genes or protein products that, along with changes in the HPV genome, can trigger out-of-control cell growth and anal cancer.
Men who test positive with the improved combo method would be considered at higher risk for anal cancer—and only that subgroup would then go on to have a biopsy taken.
Jordan hopes that the method might mean a reduction in the number of men unnecessarily sent on for the invasive testing. At the same time, the new testing algorithm could be used to screen men and quickly identify those who do need to get a definitive biopsy, which can reveal cancerous or even pre-cancerous lesions.
If the biopsy is positive, doctors can remove the abnormal lesions, a step that can prevent anal cancer. Or if the biopsy finds an outright anal cancer then it can be treated and sometimes cured if caught early enough.
Jordan and her team plan to analyze samples obtained from 250 men living with HIV who are being cared for by Dr. Stephen Abbott at Whitman-Walker Health in Washington, DC. “The goal of this grant was to design experiments that will hopefully lead us to identifying a more specific companion diagnostic to the anal Pap test,” she said.
The researchers hope to have a combination screening test that is more accurate than the current screening method identified by the end of the five-year study. If successful, the improved screening test could also be used to test other men, as well as women, who are at risk for this type of cancer, Jordan says.
About Milken Institute School of Public Health at the George Washington University: Established in July 1997 as the School of Public Health and Health Services, Milken Institute School of Public Health is the only school of public health in the nation’s capital. Today, more than 1,900 students from 54 U.S. states and territories and more than 50 countries pursue undergraduate, graduate and doctoral-level degrees in public health. The school also offers an online Master of Public Health, MPH@GW, and an online Executive Master of Health Administration, MHA@GW, which allow students to pursue their degree from anywhere in the world.