Factors associated with self-reported anal cancer screening history in men who have sex with men

Sexual Health ◽  
2019 ◽  
Vol 16 (1) ◽  
pp. 96 ◽  
Author(s):  
Joseph T. Hicks ◽  
Lu-Yu Hwang ◽  
Sarah Baraniuk ◽  
Margaret White ◽  
Elizabeth Y. Chiao ◽  
...  
Keyword(s):  
Cancer Screening ◽  
Anal Cancer ◽  
Multivariable Analysis ◽  
Computer Assisted ◽  
National Guidelines ◽  
Cancer Data ◽  
Factors Associated ◽  
Anal Cytology ◽  
Sex With Men ◽  
Anal Cancer Screening

Background Men who have sex with men (MSM) are at greater risk of developing anal cancer caused by human papillomavirus (HPV) than the rest of the general population. Currently, there are no formal national guidelines in the US advising men how and when to get anal cancer screening. We sought to assess differences in demographics, familiarity and anxiety about anal cancer among men who report having had anal cancer screening (i.e. anal cytology and/or a digital anorectal examination (DARE)). Methods: MSM were recruited to participate in a study to assess the feasibility of teaching self and partner anal examinations as a means of screening for anal cancer. Data for this secondary analysis were obtained using a written pre-test and a computer-assisted self-interview. Factors associated with screening were assessed with multivariable logistic regression to allow calculation of adjusted odds ratios (aORs). Results: Of the 197 participants with data, 145 (73.6%) reported having had anal cancer screening (either anal cytology, DARE or both) during their lifetime. Men who were younger, Black and HIV-negative were associated with decreased odds of reporting any type of anal cancer screening. For example, compared with White men, Black men were 80% less likely to report screening (aOR 0.2; 95% confidence interval (CI) 0.1–0.5). Self-perception of anal cancer knowledge was not associated with screening in multivariable analysis (aOR 1.6; 95% CI 0.6–3.9). Conclusions: Age, race and HIV status were independently associated with a history of anal cancer screening.

scholarly journals Economic barriers, evidentiary gaps, and ethical conundrums: a qualitative study of physicians’ challenges recommending HPV vaccination to older gay, bisexual, and other men who have sex with men

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Daniel Grace ◽  
Mark Gaspar ◽  
Ron Rosenes ◽  
Ramandip Grewal ◽  
Ann N. Burchell ◽  
...  
Keyword(s):  
Cancer Screening ◽  
Anal Cancer ◽  
Hpv Vaccine ◽  
Service Providers ◽  
Hpv Vaccination ◽  
National Guidelines ◽  
Therapeutic Benefits ◽  
Economic Barriers ◽  
Sex With Men ◽  
Anal Cancer Screening

Abstract Background The human papillomavirus (HPV) is the most common sexually transmitted infection (STI) worldwide. Gay, bisexual, and other men who have sex with men (GBM), and GBM living with HIV in particular, are disproportionately impacted by HPV-associated cancers. The HPV vaccine, given early enough in life, may markedly reduce the likelihood of such cancers. In Canada, most provincial insurance programs only cover HPV vaccination for GBM up to the age of 26. Our objective was to understand physicians’ everyday experiences and challenges in recommending HPV vaccination to older GBM patients. Methods As part of the HPV Screening and Vaccine Evaluation (HPV-SAVE) Study, we conducted semi-structured interviews with 25 HIV-positive GBM patients who had received anal cancer screening and 15 service providers, including 13 physicians, who had arranged for anal cancer screening in the Canadian provinces of Ontario and British Columbia. In this analysis, we draw upon the 13 physician interviews, which were coded following Grounded Theory. Results Physicians strongly supported the HPV vaccine for all GBM and considered it to be important for the management of HIV-related care. However, the overall support for HPV vaccination among physicians did not translate into consistent recommendation practices. There were two overarching factors that limited the strength/frequency of physicians’ vaccine recommendation practices. First, cost/insurance coverage for some older patients impacted if and how the HPV vaccine was discussed. Second, physicians had diverse perspectives on both the prevention and therapeutic benefits of vaccinating older GBM and the reality that national guidelines are incongruent with publicly funded vaccine programs for vaccinating patients over 26 years old. These two interrelated factors have co-produced an apparent economic-evidentiary conundrum for many physicians regarding how and for whom to offer HPV vaccination. Conclusion Economic barriers coupled with evidentiary and guideline gaps have created clinical practice challenges for physicians and has resulted in different messages being communicated to some older GBM patients about how important HPV vaccination is for their health.

Factors associated with anal cancer screening uptake in men who have sex with men living with HIV

2020 ◽  
Vol 29 (1) ◽  
pp. 1-6
Author(s):  
Alexis Vanhaesebrouck ◽  
Simon Pernot ◽  
Juliette Pavie ◽  
Marie-Laure Lucas ◽  
Lio Collias ◽  
...  
Keyword(s):  
Cancer Screening ◽  
Anal Cancer ◽  
Factors Associated ◽  
Screening Uptake ◽  
Sex With Men ◽  
Anal Cancer Screening ◽  
Living With Hiv

mRNA Biomarker in Anal Cytology: A Feasible Approach for Anal Cancer Screening in Men Who Have Sex with Men Living with HIV

2019 ◽  
Author(s):  
Marta del Pino ◽  
Cristina Martí ◽  
Jina Gaber ◽  
Cecilia Svanholm-Barrie ◽  
Leonardo Rodríguez-Caruchio ◽  
...  
Keyword(s):  
Cancer Screening ◽  
Anal Cancer ◽  
Anal Cytology ◽  
Sex With Men ◽  
Anal Cancer Screening ◽  
Living With Hiv

scholarly journals mRNA Detection in Anal Cytology: A Feasible Approach for Anal Cancer Screening in Men Who Have Sex with Men Living With HIV

Diagnostics ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. 173
Author(s):  
Pino ◽  
Martí ◽  
Gaber ◽  
Svanholm-Barrie ◽  
Rodríguez-Carunchio ◽  
...  
Keyword(s):  
Cancer Screening ◽  
Anal Cancer ◽  
Intraepithelial Neoplasia ◽  
Low Grade ◽  
Mrna Detection ◽  
Hpv Test ◽  
Screening Strategies ◽  
Sex With Men ◽  
Anal Cancer Screening ◽  
Living With Hiv

There is growing interest in anal cancer screening strategies. However, cytological/molecular evaluation of anal samples is challenging. We aimed to determine the feasibility of detecting, in anal liquid-based cytologies, the expression of biomarkers involved in the cell cycle disturbance elicited by human papillomavirus (HPV). The accuracy of this approach in the identification of high-grade squamous intraepithelial lesions/anal intraepithelial neoplasia grade2–3 (HSIL/AIN2–3) was also evaluated. 215 anal cytologies from men having sex with men living with human immunodeficiency virus were evaluated. Patients showing concordant cytological and anoscopy-directed biopsy diagnosis were selected: 70 with negative cytology and HPV test, 70 with low-grade SIL (LSIL/AIN1) cytology and biopsy, and 75 with cytology and biopsy of HSIL/AIN2–3. CDKN2A/p16, MKI67 and TOP2A mRNA expression was analyzed. HPV detection was performed with Xpert HPV Assay (Cepheid, Sunnyvale, CA, USA). HSIL/AIN2–3 showed higher expression for the biomarkers than LSIL/AIN1 or negative samples. The specificity for HSIL/AIN2–3 detection for a sensitivity established at 70% was 44.7% (95%confidence interval [CI] 36.5–53.2) for TOP2A and MKI67 and 54.5% (95%CI 46.0–62.8%) for CDKN2A/p16. mRNA detection of cell biomarkers in anal liquid-based cytology is feasible. Further studies are warranted to confirm if strategies based on mRNA detection have any role in anal cancer screening.

Cytology in Anal Cancer Screening: Practical Review for Clinicians

2019 ◽  
Vol 64 (4) ◽  
pp. 281-287 ◽  
Author(s):  
Andreia Albuquerque
Keyword(s):  
Cancer Screening ◽  
High Risk ◽  
Anal Cancer ◽  
Risk Groups ◽  
Hiv Positive ◽  
Solid Organ ◽  
Anal Squamous Cell Carcinoma ◽  
Incidence And Mortality ◽  
Anal Cytology ◽  
Anal Cancer Screening

The incidence and mortality of anal squamous cell carcinoma (SCC) are expected to continue to increase in the next 20 years. High-risk groups for anal SCC, i.e., human immunodeficiency virus (HIV)-positive patients, men who have sex with men (MSM), women with previous genital neoplasia, and solid-organ transplant recipients, have been identified. HIV-positive MSM have the highest risk, and some societies have advocated for anal cancer screening to be done in this population. Screening for anal SCC follows the same principles as that for cervical cancer since there are similarities between the two types of cancers. Anal cytology has been recommended as an initial screening method for high-risk groups, e.g., HIV-positive MSM. Normally, the cytology is liquid based and collected blindly by a clinician using a Dacron swab and it is especially used for internal lesions detection. The sensitivity to predict anal high-grade squamous intraepithelial lesions is higher in immunosuppressed patients with a high burden of the disease. The report should include the classification, normally according to the Bethesda terminology and the sample adequacy, in a manner similar to that for cervical cytology. In cases involving unsatisfactory samples, it is important to repeat the procedure given the prevalence of anal squamous cytological abnormalities in follow-up cytology procedures. The absence of transformation zone cells in anal cytology seems to increase the risk of false-negative results.

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