No Time for That: Health Care Economics and Population Health Limitations of Anal Cancer Screening

High-resolution anoscopy has become an integral component of recommended anal cancer screening in broad populations. While high-resolution anoscopy has been shown to decrease the rate of anal cancer in high-risk populations with known high-grade squamous intraepithelial lesions, it may have low utility as a broader population screening tool. Its applicability and implementation are limited by the current number of trained providers, high monetary costs, and high opportunity costs to patients and providers. Efforts to enhance its attractiveness should focus on decreasing the ratio of the number of procedures per available provider, better illustrating costs, and clear and precise national guidelines.