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This emphasizes the urgent need for an internationally standardized protocol as a prerequisite for implementation of such screening into clinical practice.
The ethical as well as financial implications must be explored and defined before implementation of such screening becomes a normal standard of practice.
The opportunity to prevent cervical cancer in women living with HIV infection should not be missed; successful implementation of such screening programs will also teach valuable lessons that could then be applied to all women [ 5].
Because of the widely recognized benefits of screening for cervical cancer, there is considerable enthusiasm for anal cancer screening in high-risk populations such as HIV-infected MSM, however, little is known about current implementation of such screening practices across jurisdictions.
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Successes of such screening campaigns critically depend on the quality of the screened library.
There are also legal and ethical issues surrounding meconium testing and its use as a universal screening tool (see Dickens [ 49]), which need to be resolved before implementation of such a screening program takes place.
The commercial availability of the "Sniffin' Sticks" assay [24], a widely used clinical test for olfaction, should ease the implementation of such a screening initiative.
An initial path to implementation of such a screening program could be through governmental or nongovernmental organizations that either purchase or monitor large quantities of medications in low-resource settings.
Even allowing for an initial increase in incidence, followed by a later reduction in rates among trial participants, as it could be expected after the implementation of such a screening programme, we feel that this had little bearing on our overall findings.
High-throughput virtual screening is a means of accomplishing the goal of screening a library of molecules for potential drug activity, and the implementation of such virtual bioactivity screening relies on the development of predictive quantitative structure-activity relationship (QSAR) models.
The implementation of such risk-stratified screening will eventually depend on a wide array of organisational, ethical, legal and social factors in addition to usefulness and cost-effectiveness [62].
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