Preparing for Anal Cancer Screening Implementation in Wisconsin

Project Summary:

In 2024, the U.S. Department of Health and Human Services recommended anal cancer screening for populations at increased risk for squamous cell carcinoma of the anus (SCCA), creating a timely opportunity to address Wisconsin’s growing burden of anal cancer. Wisconsin ranks among the states with the steepest increases in new SCCA cases and deaths, reflecting later-stage diagnoses and limited screening uptake. The goal of SCCA screening is to detect precancers, which are far easier to treat than invasive cancer. Yet screening remains rare in Wisconsin, and the factors limiting implementation are not well understood. This 24-month project will identify barriers and facilitators to implementing SCCA screening among high-risk populations and the providers and systems that serve them. The protect team will assess healthcare provider barriers and facilitators to SCCA screening and readiness to implement SCCA screening through a survey of HIV providers, primary care physicians, and transplant providers across Wisconsin; assess patient barriers and facilitators to SCCA screening, including awareness and acceptability of anal cancer screening, through interviews and surveys with people with HIV, gay and bisexual men and transgender women without HIV, and solid organ transplant recipients; and integrate mixed method findings to develop actionable recommendations to accelerate screening implementation in Wisconsin. The project will yield new, Wisconsin-specific data on provider and patient barriers to SCCA screening, along with concise recommendations to increase screening uptake, including outlines for brief provider training and patient education materials. Findings will be disseminated through established education channels, such as the Midwest AIDS Training and Education Center (MATEC) and the Wisconsin Medical Society, to inform statewide implementation and support earlier detection and improved health equity.