In 2024 – the most recent estimates – the American Cancer Society anticipated about 10,540 new cases of anal cancer, up from 8,590 new cases in 2020. The incidence rate has doubled over the last decade. This alarming trend underscores the urgent need for improved preventive measures, early diagnosis and effective treatment strategies
Two years ago, surgeon Syed Husain, MBBS, addressed this pressing need by launching a groundbreaking anal cancer screening program, focused on the prevention, early detection and optimal treatment of anal cancer.
This clinic, housed at Ohio State Martha Morehouse Outpatient Care, was established to ensure that those at high risk for anal cancer receive the most appropriate care. Dr. Husain, the clinic’s lead physician, has been instrumental in its development and success.
“I think the biggest success for us is the fact that we are providing a service that is critical for our community, and it’s the first of its kind in the state and surrounding regions,” Dr. Husain says.
In the past year, the program has grown significantly. When the program started, the clinic was open four days a month. Its services are now available Monday through Friday. In addition to Dr. Husain and colorectal surgeon Emily Huang, MD, the team now includes two nurse practitioners – Jessica Walter, APRN-CNP, and Stephanie Mitchem, APRN-CNP – allowing for daily clinics. The screening exams are done in an outpatient setting, taking less than an hour, which is more convenient and less costly for patients.
“The exam itself takes anywhere between 45 minutes to an hour. Patients come in, get it done and go home the same day. Most patients can return to work afterward,” Dr. Husain says.
Identifying the need
Over the years, it became evident that many patients referred to The Ohio State University Wexner Medical Center hadn’t consistently received the high standard of care they deserved before arriving at our clinic.
“We would see a lot of patients who presented with advanced disease because they did not get appropriate screening or early preventive care, or once they had a diagnosis, they might have gotten lost in the system or did not get appropriate follow-up,” says Dr. Husain, a clinical professor of Surgery in the Division of Colon and Rectal Surgery in the Ohio State College of Medicine.
People with HIV and those in the LGBTQIA+ community are among those at highest risk for anal cancer. They also tend to have the worst outcomes, particularly if they belong to racial or ethnic minority groups.
“Some of that has to do with social issues and poor insurance, but some of it has to do with provider bias that, unfortunately, to this day exists,” Dr. Husain says. “Our hope is to provide dignified care so that patients will feel comfortable coming to us. We foster a welcoming environment that treats every person, regardless of who they are, where they’re coming from or what type of insurance they have, with the same amount of dignity and respect we provide any other patient.”
Establishing the next crucial step
Dr. Husain is now gearing up to extend the program’s reach to women with HPV. The overwhelming majority of anal cancers are linked to infection with human papillomavirus (HPV), now the most common sexually transmitted infection in the country. While well-established screening protocols exist for cervical cancer, no such guidelines exist for anal cancer.
The clinic is working to figure out who should be screened for anal cancer and when, what screening methods work best and how to monitor those at high risk effectively.
“We hope to catch abnormal cells before they turn into cancer,” Dr. Husain says.
One of the main challenges the team has found is educating both patients and physicians about the importance of screening, especially for women with HPV infections.
“Our next big campaign will be to engage with community physicians to make sure that women in our community understand the risks and are getting the care they need,” he says.
Moving forward, this essential clinic will continue elevating care for people at risk for anal cancer and those who have the disease, not only at OSUCCC – James but nationwide. Through education, screening and research, Dr. Husain and the team will remain a resource for such a critical need in our community and beyond.