scholarly journals Why a special issue on anal cancer and what is in it?

Sexual Health ◽  
2012 ◽  
Vol 9 (6) ◽  
pp. 501 ◽  
Author(s):  
Christopher K. Fairley ◽  
Julia M. L. Brotherton ◽  
Richard Hillman ◽  
Andrew E. Grulich
Keyword(s):  
Cancer Screening ◽  
Anal Cancer ◽  
Hpv Vaccine ◽  
Intraepithelial Neoplasia ◽  
Hpv Infection ◽  
Heterosexual Men ◽  
Special Issue ◽  
Men And Women ◽  
Sex With Men ◽  
Anal Cancer Screening

This editorial describes the contents of this special issue of Sexual Health devoted to anal cancer. The aim of the issue is to provide readers with information to assist them in making decisions about what to do about detecting anal cancer early in men who have sex with men with HIV. Should they be advocating screening? It discusses the epidemiology of HPV infection, anal intraepithelial neoplasia, and anal cancer in MSM, heterosexual men and women; anal cancer screening and treatment of anal cancer. And most importantly, what should be done about vaccinating boys with the HPV vaccine.

11. Prevalence of anal high risk human papilloma virus (hr-HPV) infection and cytological

Sexual Health ◽  
2013 ◽  
Vol 10 (6) ◽  
pp. 575
Author(s):  
Sumanth Gandra ◽  
Aline Azar ◽  
Nisha Kini ◽  
Bruce Barton ◽  
Mireya Wessolossky
Keyword(s):  
Cancer Screening ◽  
Anal Cancer ◽  
Hpv Infection ◽  
Heterosexual Men ◽  
Abnormal Cytology ◽  
Hiv Patients ◽  
Men And Women ◽  
Anal Cytology ◽  
Cytological Abnormalities ◽  
Anal Cancer Screening

Background Although anal HPV infection and cytological abnormalities are highly prevalent among HIV-infected MSM patients, there is limited data on HIV-infected heterosexual men and women. Since November 2010 at our clinic, anal cancer screening with both hr-HPV and cytology was routinely performed in all HIV-infected patients. The purpose of the study was to evaluate the prevalence of anal hr-HPV infection and cytological abnormalities among our cohort of HIV-infected MSM, heterosexual men and women. We also evaluated the performance of hr-HPV and abnormal cytology in detecting high-grade dysplasia (AIN2+). Methods: A retrospective cohort study was conducted in HIV patients who underwent routine screening for anal cancer from January 2011 to January 2013. The hr-HPV test is done concomitantly on an anal cytology specimen using the Hybrid Capture 2 assay (Digene Corporation). Medical records of patients who underwent high-resolution anoscopy (HRA) because of abnormal cytology (ASCUS and above) or positive hr-HPV were reviewed. Results: A total of 221 HIV patients underwent screening with both hr-HPV and anal cytology. Among them, 67% were men (73% MSM vs 27% heterosexual). hr-HPV was positive in 43% (54% MSM, 28% non-MSM and 27% women). Anal cytology was abnormal in 39% (48% MSM, 28% non-MSM and 34% of women). Among 117 (53%) patients with an abnormal screening test, 27% had both hr-HPV infection and abnormal cytology, 14% had only hr-HPV infection and 13% had only abnormal cytology. Cytology results were normal in 50%, non-diagnostic in 10%, ASCUS in 23%, LSIL in 14% and HSIL in 2%. Among 68 HIV patients who underwent HRA because of either abnormal anal cytology or hr-HPV infection, 22 patients had AIN2+ (17 were MSM) and all had hr-HPV. None of 14 patients with negative hr-HPV who underwent HRA for abnormal cytology had AIN2+. Paired results of cytology and biopsy did not correlate (rs = –0.13). Conclusions: Anal hr-HPV infection, cytological abnormalities and AIN2+ are prevalent among our cohort of HIV-infected heterosexual men and women. We suggest anal cancer screening for all HIV-infected patients. In our limited sample, hr-HPV performed better than anal cytology in detecting and ruling out AIN2+.

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.

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.

Evaluation of an HPV/Anal Cancer Screening Awareness Program for HIV-infected Men Who Have Sex With Men

2015 ◽  
Vol 26 (4) ◽  
pp. 492-497 ◽  
Author(s):  
Eric A. Fenkl ◽  
Elie Schochet ◽  
Sandra Gracia Jones ◽  
Bruno R. da Costa
Keyword(s):  
Cancer Screening ◽  
Anal Cancer ◽  
Awareness Program ◽  
Sex With Men ◽  
Anal Cancer Screening

scholarly journals Anal Cancer Screening Behaviors and Intentions in Men Who Have Sex with Men

2008 ◽  
Vol 23 (9) ◽  
pp. 1452-1457 ◽  
Author(s):  
Gypsyamber D’Souza ◽  
Robert L. Cook ◽  
David Ostrow ◽  
Lisette M. Johnson-Hill ◽  
Dorothy Wiley ◽  
...  
Keyword(s):  
Cancer Screening ◽  
Anal Cancer ◽  
Sex With Men ◽  
Anal Cancer Screening ◽  
Screening Behaviors

30. Recognising and treating anal cancer: training medical students and physicians in Puerto Rico

Sexual Health ◽  
2013 ◽  
Vol 10 (6) ◽  
pp. 584
Author(s):  
Ana P. Ortiz ◽  
Humberto M. Guiot ◽  
Olga L. Díaz-Miranda ◽  
Leticia Romáán ◽  
Joel Palefsky ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Puerto Rico ◽  
Cancer Screening ◽  
Medical Students ◽  
Anal Cancer ◽  
Intraepithelial Neoplasia ◽  
Educational Activity ◽  
Current Status ◽  
Post Test ◽  
Anal Cancer Screening

Background Knowledge about epidemiology, diagnosis and treatment of anal neoplasia is limited among medical students and physicians from Puerto Rico (PR). Methods: Educational activity (1.5 contact hours) about anal cancer for a group of medical students, residents and faculty from the University of PR (n = 50). A 6-item pre- and post-test on anal cancer was given to assess the change in knowledge. Results: Thirty-four participants (68%) answered the survey. Overall, 78.8% had not received training in anal cancer screening and 93.9% were interested in receiving this training. Most (75.8%) were interested in participating in a clinical trial. An increase in the test scores was observed after the activity (pre-test: 3.4 ± 1.2; post-test: 4.7 ± 0.71). Three items showed an increment in the post-test that assessed participants’ knowledge regarding: (1) current status of guidelines for the screening/treatment of patients with HPV-related anal disease; (2) that anal intraepithelial neoplasia (AIN) 2 is considered to be a form of high-grade AIN (HGAIN); and (3) that warty growths in the anus are not necessarily a manifestation of HGAIN. Conclusions: This educational activity increased the participants’ knowledge of anal cancer and revealed that most of them were interested in future training and in collaborating in clinical trials. Training physicians from PR on anal cancer and clinical trials is essential to encourage recruitment of Hispanic patients in these studies now that the guidelines in anal cancer screening and treatment are on their way to being defined.

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