Professional resources

The Homerton anal neoplasia service welcomes referrals.

Please complete the HANS referral form and email to

From HANS:

Albuquerque A, Cappello C, Cuming T, De Masi A, Bowring J, Rosenthal AN, Nathan M. Anal High-Grade Squamous Intraepithelial Lesions in Pharmacologically Immunocompromised Patients Followed in a Referral Center. Dis Colon Rectum. 2018 Nov;61(11):1267-1272. doi: 10.1097/DCR.0000000000001214. PMID: 30239398.

Cappello C, Cuming T, Bowring J, Rosenthal AN, Chindawi N, Nathan M. High Resolution Anoscopy Surveillance After Anal Squamous Cell Carcinoma: High-Grade Squamous Intraepithelial Lesion Detection and Treatment May Influence Local Recurrence. Dis Colon Rectum. 2020 Aug 18. doi: 10.1097/DCR.0000000000001750. Epub ahead of print. PMID: 32868556.

De-Masi A, Davis E, Cuming T, Chindawi N, Pesola F, Cappello C, Chambers S,
Bowring J, Rosenthal AN, Sasieni P, Nathan M. The acceptability of high
resolution anoscopy examination in patients attending a tertiary referral centre.
BMC Cancer. 2018 May 11;18(1):554. doi: 10.1186/s12885-018-4475-6.

Albuquerque A, Sheaff M, Stirrup O, Cappello C, Bowring J, Cuming T, de Masi
A, Rosenthal AN, Nathan M.
Performance of Anal Cytology Compared With
High-Resolution Anoscopy and Histology in Women With Lower Anogenital Tract
Clin Infect Dis. 2018 Apr 5. doi: 10.1093/cid/ciy273

Tamzin Cuming, Mayura Nathan.
Anal cancer screening: Techniques and guidelines,
Seminars in Colon and Rectal Surgery.
Volume 28, Issue 2, June 2017,Pages 69-74,
ISSN 1043-1489,

Letter: Tamzin Cuming, Mayura Nathan, Sanjaya Wijeyekoon.
Anal cancer rates quadruple among UK women in past 40 years
BMJ 2014; 348 doi:  (Published 06 June 2014)

Lawton MD, Nathan M, Asboe D.
HPV vaccination to prevent anal cancer in men who have sex with men.
Sex Transm Infect. 2013 Aug;89(5):342-3. doi:10.1136/sextrans-2013-051176.

Nathan M.
Treatment of anal intraepithelial neoplasia: has it come of age?
AIDS. 2013 Feb 20;27(4):651-2. doi: 10.1097/QAD.0b013e32835d0e0f. PubMed PMID:

Nathan M, Sheaff M, Fox P, Goon P, Gilson R, Lacey C.
Early treatment of anal intraepithelial neoplasia.
BMJ. 2011 Nov 29;343:d7717. doi: 10.1136/bmj.d7717.
PubMed PMID: 22127454.

Shah SH, Parameswaran S, Hickey N, Zetler S, Nathan M.
Multifocal intraepithelial neoplasia and the psychological consequence of vulvectomy.
BMJ Case Rep. 2011 Jul 20;2011. pii: bcr0220113827. doi: 10.1136/bcr.02.2011.3827.
PubMed PMID: 22689657; PubMed Central PMCID: PMC4545106.

Fox PA, Nathan M, Francis N, Singh N, Weir J, Dixon G, Barton SE, Bower M.
A double-blind, randomized controlled trial of the use of imiquimod cream for the treatment of anal canal high-grade anal intraepithelial neoplasia in HIV-positive MSM on HAART, with long-term follow-up data including the use of open-label imiquimod.
AIDS. 2010 Sep 24;24(15):2331-5. doi: 10.1097/QAD.0b013e32833d466c. PubMed PMID: 20729710.

Mahto M, Nathan M, O'Mahony C.
More than a decade on: review of the use of imiquimod in lower anogenital intraepithelial neoplasia.
Int J STD AIDS. 2010 Jan;21(1):8-16. doi: 10.1258/ijsa.2009.009309. Review. PubMed PMID: 20029061.

Nathan M, Singh N, Garrett N, Hickey N, Prevost T, Sheaff M.
Performance of anal cytology in a clinical setting when measured against histology and high-resolution anoscopy findings.
AIDS. 2010 Jan 28;24(3):373-9. doi:10.1097/QAD.0b013e328333ab8e. PubMed PMID: 20057313.

Nathan M, Hickey N, Mayuranathan L, Vowler SL, Singh N.
Treatment of anal human papillomavirus-associated disease: a long term outcome study.
Int J STD AIDS. 2008 Jul;19(7):445-9. doi: 10.1258/ijsa.2007.007290. PubMed PMID: 18574114.

Maw RD, Kinghorn GR, Bowman CA, Goh BT, Nayagam AT, Nathan M.
Imiquimod 5% cream is an acceptable treatment option for external anogenital warts in uncircumcised males.
J Eur Acad Dermatol Venereol. 2002 Jan;16(1):58-62. PubMed PMID: 11952292.

Nathan M.
Outpatient treatment of intrameatal warts in a genitourinary
medicine department.
Int J STD AIDS. 1994 May-Jun;5(3):218-20. PubMed PMID: 8061096.

International Collaboration:

Hillman R, Cuming T, Jay N, Goldstone S, Berry-Lawhorn M, Barroso L, Nathan M, Palefsky J. Do we really need guidelines for high resolution anoscopy during the COVID-19 pandemic? - Response. Colorectal Dis. 2020 Jun 21:10.1111/codi.15203. doi: 10.1111/codi.15203. Epub ahead of print. PMID: 32564503; PMCID: PMC7323216.

Van der Zee RP, Richel O, van Noesel CJM, Cioc─ânea-Teodorescu I, van Splunter AP, Ter Braak TJ, Nathan M, Cuming T, Sheaff M, Kreuter A, Meijer CJLM, Quint WGV, de Vries HJC, Prins JM, Steenbergen RDM. Cancer risk stratification of anal intraepithelial neoplasia in HIV-positive men by validated methylation markers associated with progression to cancer. Clin Infect Dis. 2020 Apr 8:ciaa397. doi: 10.1093/cid/ciaa397. Epub ahead of print. PMID: 32266940.

Hillman RJ, Berry-Lawhorn JM, Ong JJ, Cuming T, Nathan M, Goldstone S, Richel O, Barrosso LF, Darragh TM, Law C, Bouchard C, Stier EA, Palefsky JM, Jay N; International Anal Neoplasia Society. International Anal Neoplasia Society Guidelines for the Practice of Digital Anal Rectal Examination. J Low Genit Tract Dis. 2019 Apr;23(2):138-146. doi: 10.1097/LGT.0000000000000458. PMID: 30907777.

Participants in an international anal neoplasia society (IANS) collaboration:

Hillman RJ, Cuming T, Darragh T, Nathan M, Berry-Lawthorn M, Goldstone S, Law C, Palefsky J, Barroso LF, Stier EA, Bouchard C, Almada J, Jay N. 2016 IANS
International Guidelines for Practice Standards in the Detection of Anal Cancer
J Low Genit Tract Dis. 2016 Oct;20(4):283-91. doi:10.1097/LGT.

Patel J, Salit IE, Berry MJ, de Pokomandy A, Nathan M, Fishman F, Palefsky J, 
Tinmouth J.
Environmental scan of anal cancer screening practices: worldwide survey results.
Cancer Med. 2014 Aug;3(4):1052-61. doi: 10.1002/cam4.250.

Other collaborations

Bissett SL, Howell-Jones R, Swift C, De Silva N, Biscornet L, Parry JV,
Saunders NA, Nathan M, Soldan K, Szarewski A, Cuzick J, Beddows S.
Human papillomavirus genotype detection and viral load in paired genital and urine samples from both females and males.
J Med Virol. 2011 Oct;83(10):1744-51. doi:10.1002/jmv.22167. Erratum in: J Med Virol. 2011 Dec;83(12):2237. PubMed PMID:21837790.

Woodhall SC, Jit M, Soldan K, Kinghorn G, Gilson R, Nathan M, Ross JD, Lacey
CJ; QOLIGEN study group.
The impact of genital warts: loss of quality of life and cost of treatment in eight sexual health clinics in the UK.
Sex Transm Infect. 2011 Oct;87(6):458-63. doi: 10.1136/sextrans-2011-050073. Epub 2011 Jun 2. PubMed PMID: 21636616; PubMed Central PMCID: PMC3253069.

Scarpini C, White V, Muralidhar B, Patterson A, Hickey N, Singh N, Mullerat J,
Winslet M, Davies RJ, Phillips ML, Stacey P, Laskey RA, Miller R, Nathan M,
Coleman N.
Improved screening for anal neoplasia by immunocytochemical detection 
of minichromosome maintenance proteins.
Cancer Epidemiol Biomarkers Prev. 2008 Oct;17(10):2855-64. doi: 10.1158/1055-9965.EPI-08-0288. PubMed PMID: 18843031.