While the incidence of most cancers affecting men has dropped in the last decade, anal cancer has become steadily more common. This increase is attributable, at least in part, to high incidence rates among men who have sex with men (MSM), especially those living with HIV/AIDS.
More than 70 percent of anal cancer cases are linked to high-risk types of human papillomavirus (HPV), which are found in more than 35 percent of MSM who are HIV-positive.
[Photo: An increase in the cases of anal cancer over the last decade is attributable, at least in part, to high incidence rates among men who have sex with men (MSM), especially those living with HIV/AIDS. A UNC study found that a majority of self-identified gay and bisexual men, particularly those who thought of themselves as high-risk for the cancer, would be willing to take an at-home screening test. Photo courtesy of Gary John Norman/Getty Images]
Researchers who study anal cancer have found that regular screenings may be an important strategy for preventing anal cancer in men. Among women, routine Pap tests have resulted in a dramatic drop in cervical cancer cases. Anal and cervical cancers are very similar, and the accuracy of anal Pap tests is similar to the cervical variety.
As clinicians are starting to recommend that high-risk men, including HIV-positive MSM, be screened for anal cancer, two researchers from the UNC-Chapel Hill Gillings School of Global Public Health co-authored a study examining gay and bisexual men’s willingness to self-administer screening tests at home.
Dr. Joshua A. Thompson, a Gillings School alumnus currently in the University of Pennsylvania Family Medicine Residency Program, led the study with multiple co-authors. Other researchers included Dr. Noel T. Brewer, associate professor of health behavior at the Gillings School. Dr. Brewer is also chair of the National HPV Vaccination Roundtable and adjunct professor in the UNC Department of Psychology.
Co-authors Dr. Paul L. Reiter and Dr. Annie-Laurie McRee both trained with Dr. Brewer in the past – Dr. Reiter as a postdoctoral fellow at UNC’s Lineberger Comprehensive Cancer Center and Dr. McRee during her dissertation process in the Gillings School’s maternal and child health department.
After conducting two national online surveys of self-identified gay and bisexual men ages 18 to 59, the researchers found that the majority of men are willing to use at-home screening tests (78 percent in one survey and 67 percent in the other).
The study team also learned that male participants were more willing to conduct a self-collected test at home than visit a doctor’s office for a screening at a cost of $150. If the doctor’s visit were free, just under half of participants said they would still choose to conduct an at-home test.
Other factors also influenced men’s willingness to self-screen. Men who felt they were at high risk for anal cancer were more willing, as were men who trusted anal Pap tests to identify cancer at a treatable stage.
Overall, allowing men the option of home testing could be an effective way to reduce mortality from anal cancer by increasing early identification through screening.
“As we learn more about the unique health risks facing gay and bisexual men, we are discovering that our efforts to address those issues may need to be equally unique,” said lead researcher Dr. Thompson. “Any future work to screen this community for anal dysplasia should consider home-based screening tests as part of those projects.”
The full research findings are available in a paper titled, “Gay and Bisexual Men’s Willingness to Use a Self-Collected Anal Cancer Screening Test”, published online June 16 by the Journal of Lower Genital Tract Disease.