{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T12:21:31Z","timestamp":1790079691200,"version":"4.0.1"},"reference-count":43,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"University of Toronto Department of Family and Community Medicine Non-Clinician Scientist award"},{"name":"Canada Research Chairs (Tier 2) in Sexually Transmitted Infection Prevention"},{"name":"Michael Smith Health Research BC Health Professional Investigator Award"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Cancer Control"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:p>Most squamous cell carcinomas of the anus, or anal cancers, are attributable to persistent infection with the human papillomavirus (HPV), analogous to cervical cancer. Although rare in the general population, rates of anal cancer are high among people with immune-compromising conditions or a history of HPV-related cancers. Recent evidence demonstrates that treatment of high-grade squamous intraepithelial lesions (HSIL), a precursor of anal cancer, prevents progression to anal cancer. This has motivated the international release of several guideline statements now recommending anal cancer screening. For a new practice of cancer screening to be integrated into routine care for at-risk populations, implementation strategies will need adaptation for local settings. Our aim is to illustrate the potential value of combining the methods of implementation science with the anal screening cascade framework to support evidence-informed adoption of the guidelines across the different clinical services points where patients might undergo anal cancer screening. We point out means by which research activity could be directed, with particular attention to identifying and addressing care gaps to inform the adoption and scale-up of anal cancer screening. These approaches may help to guide local decisions regarding first steps for anal cancer screening implementation, including determining which populations may need enhanced effort, and to identify where more preparation may be needed.<\/jats:p>","DOI":"10.1177\/10732748261466365","type":"journal-article","created":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T05:10:53Z","timestamp":1783746653000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Application of the Cascade of Care Framework to Guide Evidence-Informed Implementation of Anal Cancer Screening Guidelines"],"prefix":"10.1177","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2822-2169","authenticated-orcid":false,"given":"Ann N.","family":"Burchell","sequence":"first","affiliation":[{"name":"University of Toronto"},{"name":"Unity Health Toronto"},{"name":"University of Toronto"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Troy","family":"Grennan","sequence":"additional","affiliation":[{"name":"British Columbia Centre for Disease Control"},{"name":"University of British Columbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Fahim","sequence":"additional","affiliation":[{"name":"University of Toronto"},{"name":"Unity Health Toronto"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dina","family":"Gaid","sequence":"additional","affiliation":[{"name":"Unity Health Toronto"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Apondi J.","family":"Odhiambo","sequence":"additional","affiliation":[{"name":"Unity Health Toronto"},{"name":"University of Toronto"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuk On Annie","family":"Leung","sequence":"additional","affiliation":[{"name":"McGill University Health Centre, Montreal, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,10]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.30716"},{"key":"e_1_3_5_3_2","volume-title":"Global Cancer Observatory: Cancer Today","author":"Ferlay J","year":"2024","unstructured":"Data version: Globocan 2022 (version 1.1) - 08.02.2024Ferlay J, Ervik M, Lam F. Global Cancer Observatory: Cancer Today. Lyon, France: International Agency for Research on Cancer; 2024. Accessed: 2026-05-05 Available: https:\/\/gco.iarc.who.int\/today."},{"key":"e_1_3_5_4_2","volume-title":"Global Cancer Observatory: Cancer Today","author":"Ferlay J","year":"2024","unstructured":"Ferlay J, Ervik M, Lam F, Laversanne M. Global Cancer Observatory: Cancer Today. 2024; Lyon, France: International Agency for Research on Cancer. https:\/\/gco.iarc.who.int\/today. accessed 18 June 2025"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaf073"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2201048"},{"key":"e_1_3_5_7_2","volume-title":"Treating Anal Cancer Precursor Lesions Reduces Cancer Risk for People With HIV","author":"Fernandez E","year":"2021","unstructured":"Fernandez E. Treating Anal Cancer Precursor Lesions Reduces Cancer Risk for People With HIV. 2021 8 October 2021 17 October 2022]. Available from: https:\/\/www.ucsf.edu\/news\/2021\/10\/421591\/treating-anal-cancer-precursor-lesions-reduces-cancer-risk-people-hiv"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.34850"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0000000000000878"},{"key":"e_1_3_5_10_2","volume-title":"Anal cancer screening guidelines for People Living with HIV","author":"ASHM","year":"2025","unstructured":"ASHM. Anal cancer screening guidelines for People Living with HIV. 2025 [cited Accessed 2025 June 18; Available from:https:\/\/analcancerscreening.guidelines.org.au\/"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/ddg.15719"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0000000000000458"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0000000000000768"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(13)70067-6"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.142.11.1438"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.70503"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.0068"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmedr.2025.103274"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2024.107897"},{"key":"e_1_3_5_20_2","first-page":"296","article-title":"Conceptualizing Care Continua: Lessons from HIV, hepatitis C virus, tuberculosis and implications for the development of improved care and prevention continua","volume":"4","author":"Perlman DC","year":"2016","unstructured":"Perlman DC, Jordan AE, Nash D. Conceptualizing Care Continua: Lessons from HIV, hepatitis C virus, tuberculosis and implications for the development of improved care and prevention continua. Front Public Health. 2016;4:296.","journal-title":"Front Public Health"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.1177\/09564624221114192"},{"key":"e_1_3_5_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000002948"},{"key":"e_1_3_5_23_2","doi-asserted-by":"publisher","DOI":"10.1159\/000546717"},{"key":"e_1_3_5_24_2","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2024.0244"},{"key":"e_1_3_5_25_2","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.34199"},{"key":"e_1_3_5_26_2","doi-asserted-by":"publisher","DOI":"10.1200\/GO.21.00286"},{"key":"e_1_3_5_27_2","first-page":"100598","article-title":"Colposcopy referral rates post-introduction of primary screening with human papillomavirus testing: evidence from a large British Columbia cohort study","volume":"26","author":"Gottschlich A","year":"2023","unstructured":"Gottschlich A, Gondara L, Smith LW, et al. Colposcopy referral rates post-introduction of primary screening with human papillomavirus testing: evidence from a large British Columbia cohort study. Lancet Reg Health Am. 2023;26:100598.","journal-title":"Lancet Reg Health Am"},{"key":"e_1_3_5_28_2","volume-title":"Self-reported anal cancer screening prior to release of new clinical guidelines: Results from the Ontario HIV Treatment Network (OHTN) Cohort Study. Presentation at the2025 STI & HIV World Congress","author":"Burchell AN","year":"2025","unstructured":"Burchell AN, Light L, Grennan T, Arbess G, Fahim C, et al. Self-reported anal cancer screening prior to release of new clinical guidelines: Results from the Ontario HIV Treatment Network (OHTN) Cohort Study. Presentation at the2025 STI & HIV World Congress. Montreal, Canada: \u25a0\u25a0\u25a0; 2025. on behalf of the ACCESS Study Team and the OHTN Cohort Study Team."},{"key":"e_1_3_5_29_2","doi-asserted-by":"publisher","DOI":"10.1017\/9781009237055"},{"key":"e_1_3_5_30_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-025-26179-2"},{"key":"e_1_3_5_31_2","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0065-2025"},{"key":"e_1_3_5_32_2","doi-asserted-by":"publisher","DOI":"10.1177\/22799036241268841"},{"key":"e_1_3_5_33_2","doi-asserted-by":"publisher","DOI":"10.1186\/s43058-024-00566-z"},{"key":"e_1_3_5_34_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2019.00158"},{"key":"e_1_3_5_35_2","doi-asserted-by":"publisher","DOI":"10.1186\/s43058-023-00480-w"},{"key":"e_1_3_5_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2019.112643"},{"key":"e_1_3_5_37_2","doi-asserted-by":"publisher","DOI":"10.1080\/09540121.2021.1883512"},{"key":"e_1_3_5_38_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-025-15120-w"},{"key":"e_1_3_5_39_2","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000002335"},{"key":"e_1_3_5_40_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-022-14471-4"},{"key":"e_1_3_5_41_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-023-16847-6"},{"key":"e_1_3_5_42_2","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2024.0171"},{"key":"e_1_3_5_43_2","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0000000000000598"},{"key":"e_1_3_5_44_2","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0000000000000578"}],"container-title":["Cancer Control"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10732748261466365","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10732748261466365","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10732748261466365","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T08:16:59Z","timestamp":1783930619000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10732748261466365"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":43,"alternative-id":["10.1177\/10732748261466365"],"URL":"https:\/\/doi.org\/10.1177\/10732748261466365","relation":{},"ISSN":["1073-2748","1526-2359"],"issn-type":[{"value":"1073-2748","type":"print"},{"value":"1526-2359","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6]]},"article-number":"10732748261466365"}}