Malignancy in older people with HIV infection

There is no evidence to support cancer screening at an earlier age in people with HIV infection. At each clinic visit, the opportunity should be taken to address cancer risk factors by advising smoking cessation, alcohol reduction, obesity management and treatment for HCV infection. Age-appropriate general population screening guidelines should be followed for all people with HIV infection. The only caveat to this is HPV-related cancers; annual digital ano-rectal examinations are recommended for MSM with HIV infection over 50 years of age, due to significantly higher rates of anal cancer, and improved outcomes if diagnosed at earlier pre-symptomatic stages.