Mount Sinai Receives NCI Grant to Study Anal Cancer Screening in High-Risk Women
The Icahn School of Medicine at Mount Sinai has been awarded a grant of more than $4 million by the National Cancer Institute for a large-scale study to evaluate anal cancer screening in high-risk women who have been previously diagnosed with human papillomavirus (HPV) infection. This multi-center study is a collaboration between the Mount Sinai Anal Dysplasia Screening Program, The University of Texas MD Anderson Cancer Center, and The University of Texas Health Science Center at Houston (UTHealth).
Anal cancer is one of the fastest-rising cancers—in incidence and death rates—in the United States, with the most significant increases occurring among women ages 50 and older, according to the Journal of the National Cancer Institute. Among these women, annual rates of new cases of anal cancer have grown 5 percent each year during the last two decades, and the number of new anal cancer diagnoses is expected to overtake those of cervical cancer in older women during the next decade.
The five-year trial will evaluate the effectiveness of anal cancer screening interventions for women who are not infected with HIV and who have a history of HPV-related precancers in the lower genital sites including the cervix, vagina, and vulva. Evidence of HPV infection at one genital site has been previously associated with HPV infection in the anus, as well as risk of precancers in the anus. Approximately 90 percent of anal cancers are associated with HPV infection.
By focusing on women who do not have HIV, the new study will target the population with the largest group of anal cancers in the United States, and one that has historically been understudied.
The team of doctors and researchers will screen 300 women to determine how effectively existing tests perform and to estimate the prevalence and incidence of high-risk anal precancers in this group. The research team will also utilize machine learning and mathematical modeling approaches to determine how the study findings would impact at-risk women at the population level, with estimates of the benefits, harms, impact on quality of life, and cost-effectiveness of early testing. Screenings will be conducted at two sites, the Mount Sinai Health System in New York and the MD Anderson Oncology Program at Harris Health Lyndon B. Johnson Hospital in Houston.
“Given there are currently no evidence-based guidelines for screening this high-risk group, our study will lay the groundwork for more effective evaluations of women who have been diagnosed with other conditions that may increase the risk for anal cancer,” said co-principal investigator Keith Sigel, MD, PhD, MPH, Associate Professor of Medicine (General Medicine and Infectious Diseases) at Icahn Mount Sinai. “We think that early detection and aggressive treatment of precancers may stop the progression to cancer, but there has been very little research on this disease process in this high-risk group of women. With the trend in rising cases among older women, effective prevention methods are urgently needed.”
Dr. Sigel will lead the study with Elizabeth Yu Chiao, MD, MPH, Professor of Epidemiology and General Oncology at MD Anderson, and Ashish A. Deshmukh, PhD, MPH, Assistant Professor of Management, Policy & Community Health at UTHealth School of Public Health in Houston.
“This important study builds upon our prior NCI-funded work, which focused on determining optimal anal cancer screening strategies in women and men living with HIV,” Dr. Chiao said. “It will provide the necessary data to develop evidence-based anal cancer prevention strategies for high-risk HIV-negative women.”
Dr. Deshmukh said women with a history of HPV-associated cancers represent a growing number of vulnerable and understudied individuals at elevated anal cancer risk. “This study is the first of its kind to perform a comprehensive screening evaluation to improve survivorship and quality of life of these women and inform national cancer prevention policy,” he said.
About the Mount Sinai Health System
Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with more than 43,000 employees working across eight hospitals, over 400 outpatient practices, nearly 300 labs, a school of nursing, and a leading school of medicine and graduate education. Mount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time — discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it.
Through the integration of its hospitals, labs, and schools, Mount Sinai offers comprehensive health care solutions from birth through geriatrics, leveraging innovative approaches such as artificial intelligence and informatics while keeping patients’ medical and emotional needs at the center of all treatment. The Health System includes approximately 7,300 primary and specialty care physicians; 13 joint-venture outpatient surgery centers throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and more than 30 affiliated community health centers. We are consistently ranked by U.S. News & World Report's Best Hospitals, receiving high "Honor Roll" status, and are highly ranked: No. 1 in Geriatrics and top 20 in Cardiology/Heart Surgery, Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology. New York Eye and Ear Infirmary of Mount Sinai is ranked No. 12 in Ophthalmology. U.S. News & World Report’s “Best Children’s Hospitals” ranks Mount Sinai Kravis Children's Hospital among the country’s best in 4 out of 10 pediatric specialties. The Icahn School of Medicine at Mount Sinai is one of three medical schools that have earned distinction by multiple indicators: It is consistently ranked in the top 20 by U.S. News & World Report's "Best Medical Schools," aligned with a U.S. News & World Report "Honor Roll" Hospital, and top 20 in the nation for National Institutes of Health funding and top 5 in the nation for numerous basic and clinical research areas. Newsweek’s “The World’s Best Smart Hospitals” ranks The Mount Sinai Hospital as No. 1 in New York and in the top five globally, and Mount Sinai Morningside in the top 20 globally.