ANAL CANCER SCREENING PRACTICES AMONG HIGHER-RISK POPULATIONS IN AN ACADEMIC MEDICAL SYSTEM.
Journal
Sexually transmitted diseases
ISSN: 1537-4521
Titre abrégé: Sex Transm Dis
Pays: United States
ID NLM: 7705941
Informations de publication
Date de publication:
24 Sep 2024
24 Sep 2024
Historique:
medline:
24
9
2024
pubmed:
24
9
2024
entrez:
24
9
2024
Statut:
aheadofprint
Résumé
While some experts recommend anal cancer screening for disproportionally affected populations including people living with HIV (PWH), condyloma acuminata, human papillomavirus (HPV)-associated gynecologic dysplasia and cancers, and solid organ transplants, actual screening practices remain understudied. Our objective was to characterize anal cancer screening practices among higher-risk populations in an academic medical system with access to high-resolution anoscopy (HRA). We extracted outpatient clinical data for the above populations from 01/01/2015 - 08/01/2022 at three sites of an academic medical system. Data included patients' demographics, medical comorbidities, and anal cytology and HPV testing results. We used chi-squared tests and logistic regression to assess for associations between patient characteristics and anal cancer screening. Of 7654 patients, 6.3% received anal cytology screening at least once including 21.7% of PWH, 13.8% of people with condyloma acuminata, 1.1% of people with gynecologic cancers, and 0.5% of people with solid organ transplants. In multivariable analysis, Black patients were 46% less likely to receive screening than white patients (95% confidence interval [CI] 0.40-0.71), and cisgender women were 73% less likely to receive screening than cisgender men (95% CI 0.20-0.38). Of 485 individuals who received anal cytology screening, 37.5% were only screened once and 70.5% had abnormal cytology on one or more screenings. Only one-fifth of PWH received anal cancer screening and other higher-risk populations had even lower screening rates. Black patients and women were also less likely to be screened. Strategies to improve equitable screening practices for anal cancer are needed.
Sections du résumé
BACKGROUND
BACKGROUND
While some experts recommend anal cancer screening for disproportionally affected populations including people living with HIV (PWH), condyloma acuminata, human papillomavirus (HPV)-associated gynecologic dysplasia and cancers, and solid organ transplants, actual screening practices remain understudied. Our objective was to characterize anal cancer screening practices among higher-risk populations in an academic medical system with access to high-resolution anoscopy (HRA).
METHODS
METHODS
We extracted outpatient clinical data for the above populations from 01/01/2015 - 08/01/2022 at three sites of an academic medical system. Data included patients' demographics, medical comorbidities, and anal cytology and HPV testing results. We used chi-squared tests and logistic regression to assess for associations between patient characteristics and anal cancer screening.
RESULTS
RESULTS
Of 7654 patients, 6.3% received anal cytology screening at least once including 21.7% of PWH, 13.8% of people with condyloma acuminata, 1.1% of people with gynecologic cancers, and 0.5% of people with solid organ transplants. In multivariable analysis, Black patients were 46% less likely to receive screening than white patients (95% confidence interval [CI] 0.40-0.71), and cisgender women were 73% less likely to receive screening than cisgender men (95% CI 0.20-0.38). Of 485 individuals who received anal cytology screening, 37.5% were only screened once and 70.5% had abnormal cytology on one or more screenings.
CONCLUSION
CONCLUSIONS
Only one-fifth of PWH received anal cancer screening and other higher-risk populations had even lower screening rates. Black patients and women were also less likely to be screened. Strategies to improve equitable screening practices for anal cancer are needed.
Identifiants
pubmed: 39316045
doi: 10.1097/OLQ.0000000000002081
pii: 00007435-990000000-00409
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024 American Sexually Transmitted Diseases Association. All rights reserved.
Déclaration de conflit d'intérêts
CONFLICTS OF INTEREST: The manuscript’s first author (DG) received a Small Project Assistance grant from the American Sexually Transmitted Diseases Association (ASTDA) to help fund research discussed in this manuscript. There are otherwise no conflicts of interest to report for the remaining authors.