Q&A with Dr Jeff Jin: Improving health outcomes for gay and bisexual men through anal cancer research

By Sylvia Lee | 17 June 2025 

This Pride Month, Cure Cancer is highlighting disparities in LGBTIQA+ health. We caught up with Kirby Institute researcher Dr Jeff Jin, whose Cure Cancer-funded research investigated whether HPV biomarkers could improve cancer screening for those disproportionately affected by anal cancer, particularly gay, bisexual, and other men who have sex with men (GBMSM).  

While LGBTIQA+ communities are diverse and resilient, they experience distinct health disparities that stem from stigma, discrimination, and a lack of inclusive practices in healthcare. Unfortunately, LGBTIQA+ people face a disproportionate cancer burden. They are at increased risk due to barriers to cancer screening, higher rates of smoking and alcohol use, poorer mental health, and higher risk of HPV, which is known to cause many cancers such as cervical and anal cancer.

Although anal cancer is uncommon in the general population, cases have been increasing in the last 40 years. Since 1982, the number of people in Australia diagnosed with anal cancer each year has increased from 44 to 194 in people assigned male at birth, and from 70 to 307 in people assigned female at birth. The risk is far higher among gay, bisexual, and other men who have sex with men (GBMSM), people living with HIV, and women and people assigned female at birth with a history of other HPV-related cancer or precancer in the lower genital tract. There is limited research on anal cancer risk among trans women and gender diverse people assigned male at birth, though there is emerging evidence that they may also be at higher risk.  

Gay, bisexual, and other men who have sex with men are at greater risk of anal cancer than the general population.

“Anal cancer could be one of the diseases that are associated with the highest disparities in LGBTIQA+ people,” says Dr Jeff Jin, an anal cancer researcher and epidemiologist based at the Kirby Institute at UNSW Sydney.  

“Gay, bisexual, and other men who have sex with men living with HIV have the highest risk of anal cancer than any other population subgroup, with similar rates to prostate cancer due to a high exposure to HPV and a compromised immune system,” he continues. “The risk of anal cancer is 20 times higher in GBMSM, and for those living with HIV, this risk could be up to 130 times higher.” 

Cure Cancer-funded researcher Dr Jeff Jin. Image: Cure Cancer 

Funded by Cure Cancer in 2013, Dr Jeff Jin discovered that the incidence of anal cancer in GBMSM, particularly GBMSM living with HIV, was higher than that of cervical cancer before the introduction of the National Cervical Screening Program (previously a Pap smear test). His initial research was focused on testing HPV biomarkers to determine whether they can improve anal cancer screening by finding better ways to target precancerous lesions. 

We caught up with Dr Jin to chat about anal cancer screening and prevention, how his research has progressed since 2013, and the importance of inclusive research: 

What would you like people to know about anal cancer?

Anal cancer is caused by HPV infection, a sexually transmitted infection that is preventable by the currently available HPV vaccine.  Adolescent boys and girls, and other eligible people should be vaccinated. 

Although GBMSM and people living with HIV (PLHIV) carry the highest risk for anal cancer, the bulk of the disease is in the wider community. More than half of the annual diagnoses are in women. People of known at-risk populations should discuss their anal cancer risk with their routine health providers. A simple digital anorectal examination (DARE) can detect anal cancer at an early stage when the treatment is simpler, with fewer associated morbidities and better survivorship.  

What are the current screening options for anal cancer in Australia?

There were no evidence-based anal cancer screening programs until 2024 following the success of the ANCHOR study conducted in the US. In Australia, the first guidelines for anal cancer screening in PLHIV were published by the Australasian Society for HIV Medicine in March 2025.  

Screening saves lives, so these guidelines are a real gamechanger. That said, there are still wide gaps existing between cervical and anal cancer screening in terms of knowledge around the natural history of the diseases; community and health care providers’ knowledge of anal cancer risk; and funding available for screening, treatment, and the workforce.  

Currently, there is no public funding for anal cancer screening in Australia. Either individuals or health services that provide screening tests and related treatment would bear the cost. There are only a handful of health practitioners in Sydney who are trained and qualified to do this, and even fewer doctors can offer treatment. There is no such expertise in other major cities like Melbourne and Brisbane.  

What do we currently know about anal cancer prevention?

Anal cancer is a preventable disease, and we have the tools for prevention. The key is getting them integrated into health systems and reducing stigma associated with this disease. 

Strategies for prevention include receiving the HPV vaccine as an adolescent when it is most effective to reduce the risk for anal HPV infection; screening for anal precancerous lesions to reduce the risk for cancer development, through anal HPV and cytology testing, and undergoing treatment if required; and early detection of anal cancer for better survivorship, through digital anorectal examination (DARE). 

Since being funded by Cure Cancer in 2013, what have been some breakthroughs and milestones in your initial biomarker research project?

While the biomarkers that I evaluated in my project can help improve the screening accuracy for anal cancer prevention to a certain degree, a lot of improvements are still needed before biomarkers can be used in practice. 

A Dutch group of scientists have recently reported a new biomarker, DNA methylation, has shown some promising aspects in improving anal cancer screening accuracy. We are collaborating with this group to evaluate the performance of this new tool in our studies.  

What is your proudest moment as a researcher thus far?

Seeing my research has been translated into policy and practice, like my recent publication on the triage use of anal cytology, in addition to primary HPV testing being adopted in the Australian Anal Cancer Screening Guidelines for PLHIV. Research translation into policy means improved health and wellbeing, which is something I’m incredibly proud of. 

Can you tell me about your current anal cancer research and potential outcomes for patients?

My current anal cancer research involves the surveillance of anal cancer burden in various at-risk populations. We know the incidence of anal cancer is increasing in Australia in both men and women. However, despite existing comprehensive disease registries, the burden of this disease is still uncertain in some well-defined population subgroups, including people living with HIV, women with previous HPV-associated cancers in the lower genital tract and precancers in the cervix, and solid organ transplant recipients. 

My current research also involves the evaluation of anal cancer screening algorithms. Compared with cervical cancer screening, the performance of screening tests for anal cancer is still suboptimal. This will generate a lot of false positive results and refer too many people who do not have anal pre-cancer for high-resolution anoscopy (an anal screening procedure), which risks overwhelming the current limited capacity of the health system.  

Why is it important to support research on marginalised populations like gay and bisexual men?

Gay, bisexual, and other men who have sex with men are people in our community who face unique health-related challenges in their lives. While some of these conditions are not as visible in the wider community, it is important that these disparities are dealt with to ensure nobody in our society is left behind.