# Raman-enhanced spectroscopy (RESpect) for anal dysplasia in HIV-positive patients

> **NIH NIH R21** · UNIVERSITY OF HAWAII AT MANOA · 2020 · $400,414

## Abstract

PROJECT ABSTRACT
The risk for anal cancer in HIV-positive individuals is up to 80-times higher than the general population with the
incidence among HIV-positive men ranging between 49-131/100,000 person-years which is higher than the
incidence of cervical cancer prior to universal screening with cervical cytology. Even though anal cancer
prevention can be achieved with human papillomavirus vaccination, those who are currently at highest risk for
anal cancer have already been exposed to HPV and remain at high risk for anal dysplasia/cancer. Thus,
identifying best-practices for anal cancer prevention through anal dysplasia screening in HIV-positive
individuals would be beneficial. However, acceptance of anal cytology as the gold standard for screening has
not been universally recognized due to issues related to cost-effectiveness, reliability and accuracy. Current
guidelines recommend high resolution anoscopy (HRA)-guided biopsies as a follow-up to abnormal anal
cytologies although HRA is invasive with potential downsides including patient discomfort and anxiety
associated with biopsies. Therefore, identifying less-invasive screening paradigms could revolutionize anal
cancer screening programs in this vulnerable population. The project will adapt a novel technology, Raman-
enhanced spectroscopy (RESpect), which is a laser-based tool that characterizes chemical molecular
composition of cells and tissue. The study builds upon preliminary data which demonstrated unique RESpect
fingerprints of anal dysplastic tissues from normal to low-grade squamous intraepithelial lesions (LSIL) and
high-grade squamous intraepithelial lesions (HSIL). Because standard RESpect protocol requires HRA-guided
biopsies to obtain anal tissue to identify RESpect signatures in the laboratory, an innovative approach will
adapt a novel portable fiber-optic RESpect probe to assess real-time screening and diagnosis. The central
hypotheses are: 1) RESpect fingerprints will characterize a spectrum of anal dysplasia/cancer in HIV-positive
individuals; and 2) RESpect fingerprints obtained by a portable probe are comparable to standard RESpect
signatures obtained by the RESpect instrument. The novel proposal will translate RESpect technology to anal
histologies from screening/diagnosis to potential clinical translational applications. The significance of the study
lies in contributing new knowledge and identifying novel RESpect fingerprints as biomarkers in HIV-associated
anal dysplasia/cancer which synergizes knowledge with technology to improve screening to improve
healthcare delivery.

## Key facts

- **NIH application ID:** 9856763
- **Project number:** 1R21CA244078-01
- **Recipient organization:** UNIVERSITY OF HAWAII AT MANOA
- **Principal Investigator:** Melissa Anne Agsalda-Garcia
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $400,414
- **Award type:** 1
- **Project period:** 2020-08-01 → 2025-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9856763

## Citation

> US National Institutes of Health, RePORTER application 9856763, Raman-enhanced spectroscopy (RESpect) for anal dysplasia in HIV-positive patients (1R21CA244078-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9856763. Licensed CC0.

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