The Kirby Institute at UNSW Sydney will establish a national program to significantly reduce the burden of anal cancer in people living with HIV, thanks to a $5 million donation from The Glendonbrook Foundation.
 
Kirby Institute Director, Professor Anthony Kelleher said that “anal cancer is highly stigmatised and research in the field has been neglected due to a lack of available interventions and a lack of funding”.
 
Anal cancer is increasing in Australia. It is highly concentrated in a few high-risk populations, with those at the highest risk being HIV-positive gay and bisexual men, who are 100 times more likely to develop anal cancer than men in the general population. This is due to the combination of increased risk of infection with human papillomavirus (HPV) and impaired immune function to control that infection.
 
Lord Glendonbrook has supported Kirby Institute research for 10 years through The Glendonbrook Foundation. He is a British businessman, was one of the country’s first openly gay senior executives and now has a large philanthropic portfolio through The Glendonbrook Foundation. He was made a Member of the Order of Australia (AM) for significant service to the not-for-profit sector through philanthropic support.
 
Lord Glendonbrook was drawn to the Kirby Institute’s research because of the Institute’s work with marginalised communities, particularly gay and bisexual men. 
 
“From its earliest days the Kirby Institute has responded to real community health needs and approached scientific research from the perspective of the equal right we all ought to have to healthcare, as well as the power of generating evidence to challenge stigma and discrimination,” he said.  
 
“I am honoured to support this research to reduce anal cancer in people living with HIV. This already stigmatised population urgently needs access to these life-saving preventions and treatments. The Kirby Institute is well placed to work with their partners and health services to fill what is currently a critical gap in the health system,” said Lord Glendonbrook.
 
Prof. Kelleher said, “we are extremely fortunate that our long-term supporter Lord Glendonbrook has chosen to donate such a significant amount of funding to facilitate this crucial and timely research, which will save lives.”

Simplify, then scale up: Developing a national program for anal cancer prevention for people with HIV

The $5 million in funding will support the development of a national program for screening and treatment to prevent anal cancer in people living with HIV. The work will be led by Professor Andrew Grulich at the Kirby Institute, and be conducted in close collaboration with Professor Richard Hillman at St Vincent’s Hospital Sydney and a network of researchers, clinicians and community representatives.

“Anal cancer detection is currently very complex,” said Prof. Grulich. “It is caused by certain strains of HPV, and can develop from abnormalities in the anal lining, called high-grade squamous intraepithelial lesions, or high-grade lesions. These are small non-cancerous lesions in the skin.”

Detection of these lesions requires a procedure called a High-Resolution Anoscopy, which is invasive, time-consuming, labour-intensive and needs to be performed by a specially trained clinician.

“This funding will allow us to look at innovative screening methods and technology, such as a self-collected anal swab, in order to make screening much more accessible,” said Prof. Grulich.

Dr Mary Poynten, a clinical epidemiologist at the Kirby Institute said, “Currently, less than five per cent of people living with HIV receive screening for anal cancer, despite their significantly higher risk. But through this program, we aim to scale up these innovations nationally, offering screening to all people living with HIV in Australia. This has the potential to prevent anal cancer in many people living with HIV each year”.

The program will be conducted over five years and will involve collaboration with the Dysplasia and Anal Cancer Services at St Vincent’s Hospital Sydney and Positive Life NSW.