1. What is the decision or change (e.g. clinical topic, practice guideline, system design, delivery of care) you are facing or struggling with where a summary of the evidence would be helpful?
Anal cancer is a relatively rare cancer, with a higher prevalence among patients with human immunodeficiency virus (HIV). While there are only approximately 9,440 new cases per year, the incidence of this cancer has been increasing for many years. The ASCO Gastrointestinal Guidelines Advisory Group identified a need for guidance for this patient population. This disease site is of particular interest to both ASCO and ASTRO. Although chemoradiation is the definitive treatment for anal cancer, it is a complex disease with inherent challenges especially related to radiation planning and toxicity.
2. Why are you struggling with this issue?
Clinicians need data to guide treatment with respect to indications for chemotherapy, radiation or chemoradiation. Areas of uncertainty include radiation dose and fractionation, dose de-escalation, and data to guide use of IMRT rather than 3-D CRT as well as type of chemotherapy, and potential role of immunotherapy.
3. What do you want to see changed? How will you know that your issue is improving or has been addressed?
We would like to see less uncertainty amongst clinicians regarding how to treat this disease site, and ultimately less variation in practice.
4. When do you need the evidence report?
5. What will you do with the evidence report?
The evidence report will be the basis for a clinical practice guideline.
Optional Information About You
What is your role or perspective? Professional Society Staff
If you are you making a suggestion on behalf of an organization, please state the name of the organization American Society of Clinical Oncology and American Society of Radiation Oncology
May we contact you if we have questions about your nomination? Yes