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Published in: Cancer Causes & Control 10/2017

01-10-2017 | Original paper

A qualitative investigation among men who have sex with men on the acceptability of performing a self- or partner anal exam to screen for anal cancer

Authors: Seyram A. Butame, Sylvia Lawler, Joseph T. Hicks, J. Michael Wilkerson, Lu-Yu Hwang, Sarah Baraniuk, Michael W. Ross, Elizabeth Yu Chiao, Alan G. Nyitray

Published in: Cancer Causes & Control | Issue 10/2017

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Abstract

Purpose

Persistent infection with oncogenic human papillomavirus (HPV) is the primary cause of anal cancer, a disease that disproportionately affects men who have sex with men (MSM); however, there is no uniform screening protocol to detect anal cancer. This qualitative study explores whether a self-anal exam (SAE) or partner anal exam (PAE), that includes self-palpation or palpation of a partner’s anal canal, is an acceptable and self-efficacious screening test, which will cue appropriate follow-up care in MSM.

Methods

Twenty-four MSM living in Houston took part in four focus group sessions eliciting their responses to a study teaching them to perform an SAE or PAE (SAE/PAE). Participants were asked about the acceptability and feasibility of executing an SAE/PAE routinely. Thematic analysis of session transcripts was used to identify common patterns in participant responses. Results: Overall, participants expressed self-efficacy for performing an SAE/PAE and voiced a preference for being taught the procedure by a clinician. Participants agreed that they would consult with a clinician if they ever discovered an abnormality while performing an SAE/PAE. A lack of knowledge about anal cancer among MSM may present a barrier to adopting SAE/PAE. In discussing their experience of the exams, some participants suggested that it could become a routine practice for them.

Conclusions

Our findings suggest that SAE and PAE, as a screen for anal cancer, are acceptable and feasible to MSM. Future research should explore attitudes and beliefs of MSM, with the aim of improving anal cancer education and understanding of pathologic findings.
Literature
1.
go back to reference American Cancer Society (2015) Cancer facts and figures 2015. American Cancer Society, Atlanta American Cancer Society (2015) Cancer facts and figures 2015. American Cancer Society, Atlanta
2.
go back to reference Chaturvedi AK (2010) Beyond cervical cancer: burden of other HPV-related cancers among men and women. J Adol Health 46:S20–S26CrossRef Chaturvedi AK (2010) Beyond cervical cancer: burden of other HPV-related cancers among men and women. J Adol Health 46:S20–S26CrossRef
4.
go back to reference Johnson LG et al (2004) Anal cancer incidence and survival: the surveillance, epidemiology, and end results experience, 1973–2000. Cancer 101(2):281–288CrossRefPubMed Johnson LG et al (2004) Anal cancer incidence and survival: the surveillance, epidemiology, and end results experience, 1973–2000. Cancer 101(2):281–288CrossRefPubMed
5.
go back to reference American Cancer Society (2013) Cancer facts and figures 2013. American Cancer Society, Atlanta American Cancer Society (2013) Cancer facts and figures 2013. American Cancer Society, Atlanta
6.
go back to reference D’Souza G et al (2008) Incidence and epidemiology of anal cancer in the multicenter AIDS cohort study (MACS). J Acquir Immune Defic Synd 48(4):491–499CrossRef D’Souza G et al (2008) Incidence and epidemiology of anal cancer in the multicenter AIDS cohort study (MACS). J Acquir Immune Defic Synd 48(4):491–499CrossRef
7.
go back to reference Daling JR et al (1982) Correlates of homosexual behavior and the incidence of anal cancer. J Am Med Assoc 247(14):1988–1990CrossRef Daling JR et al (1982) Correlates of homosexual behavior and the incidence of anal cancer. J Am Med Assoc 247(14):1988–1990CrossRef
8.
go back to reference Diamond C et al (2005) Increased incidence of squamous cell anal cancer among men with AIDS in the era of highly active antiretroviral therapy. Sexually Transmitted Dis 32(5):314CrossRef Diamond C et al (2005) Increased incidence of squamous cell anal cancer among men with AIDS in the era of highly active antiretroviral therapy. Sexually Transmitted Dis 32(5):314CrossRef
9.
go back to reference De Vuyst H et al (2009) Prevalence and type distribution of human papillomavirus in carcinoma and intraepithelial neoplasia of the vulva, vagina and anus: a meta-analysis. Int J Cancer 124(7):1626–1636CrossRefPubMed De Vuyst H et al (2009) Prevalence and type distribution of human papillomavirus in carcinoma and intraepithelial neoplasia of the vulva, vagina and anus: a meta-analysis. Int J Cancer 124(7):1626–1636CrossRefPubMed
10.
go back to reference Nyitray AG et al (2016) Incidence, duration, persistence, and factors associated with high-risk anal HPV persistence among HIV-negative men having sex with men: a multi-national study. Clin Infect Dis 32:314–320 Nyitray AG et al (2016) Incidence, duration, persistence, and factors associated with high-risk anal HPV persistence among HIV-negative men having sex with men: a multi-national study. Clin Infect Dis 32:314–320
12.
go back to reference Markowitz LE et al (2014) Human papillomavirus vaccination: recommendations of the advisory committee on immunization practices (ACIP), in morbidity and mortality weekly report (MMWR). Centers for Disease Control and Prevention, Atlanta Markowitz LE et al (2014) Human papillomavirus vaccination: recommendations of the advisory committee on immunization practices (ACIP), in morbidity and mortality weekly report (MMWR). Centers for Disease Control and Prevention, Atlanta
13.
go back to reference Sachez DM et al (2012) Knowledge of human papillomavirus and anal cancer among men who have sex with men attending a New York City sexually transmitted diseases clinic. Int J STD AIDS 23(1):41–43CrossRef Sachez DM et al (2012) Knowledge of human papillomavirus and anal cancer among men who have sex with men attending a New York City sexually transmitted diseases clinic. Int J STD AIDS 23(1):41–43CrossRef
14.
go back to reference Nielsen A et al (2009) Awareness of human papillomavirus in 23 000 Danish men from the general male population. Eur J Cancer Prev 18(3):236–239CrossRefPubMed Nielsen A et al (2009) Awareness of human papillomavirus in 23 000 Danish men from the general male population. Eur J Cancer Prev 18(3):236–239CrossRefPubMed
15.
go back to reference Newman PA et al (2013) HPV vaccine acceptability among men: a systematic review and meta-analysis. Sex Transmit Infect 89(7):568–574CrossRef Newman PA et al (2013) HPV vaccine acceptability among men: a systematic review and meta-analysis. Sex Transmit Infect 89(7):568–574CrossRef
16.
go back to reference Wells JS et al (2014) An integrative review of guidelines for anal cancer screening in HIV-infected persons. AIDS Pat Care STDs 28(7):350–357CrossRef Wells JS et al (2014) An integrative review of guidelines for anal cancer screening in HIV-infected persons. AIDS Pat Care STDs 28(7):350–357CrossRef
17.
go back to reference Simpson S, Turner R (2012) Four decades of anal cancer in Tasmania, Australia: what do the case data tell us? Sex Health 9(3):213–219CrossRefPubMed Simpson S, Turner R (2012) Four decades of anal cancer in Tasmania, Australia: what do the case data tell us? Sex Health 9(3):213–219CrossRefPubMed
18.
go back to reference Chin-Hong P et al (2008) Comparison of patient- and clinician-collected anal cytology samples to screen for human papillomavirus–associated anal intraepithelial neoplasia in men who have sex with men. Ann Intern Med 149(5):300–306CrossRefPubMed Chin-Hong P et al (2008) Comparison of patient- and clinician-collected anal cytology samples to screen for human papillomavirus–associated anal intraepithelial neoplasia in men who have sex with men. Ann Intern Med 149(5):300–306CrossRefPubMed
19.
go back to reference Dodge B et al (2012) Rectal self-sampling in non-clinical venues for detection of sexually transmissible infections among behaviourally bisexual men. Sex Health 9(2):190–191PubMedPubMedCentral Dodge B et al (2012) Rectal self-sampling in non-clinical venues for detection of sexually transmissible infections among behaviourally bisexual men. Sex Health 9(2):190–191PubMedPubMedCentral
20.
go back to reference Daniel WJ (2010) Anorectal pain, bleeding and lumps. Aust Fam Physician 39(6):376–381PubMed Daniel WJ (2010) Anorectal pain, bleeding and lumps. Aust Fam Physician 39(6):376–381PubMed
22.
go back to reference Newman PA et al (2008) Anal cancer screening: barriers and facilitators among ethnically diverse gay, bisexual, transgender, and other men who have sex with men. J Gay Lesbian Soc Serv 20(4):328–353CrossRefPubMedPubMedCentral Newman PA et al (2008) Anal cancer screening: barriers and facilitators among ethnically diverse gay, bisexual, transgender, and other men who have sex with men. J Gay Lesbian Soc Serv 20(4):328–353CrossRefPubMedPubMedCentral
23.
go back to reference Darragh TM, Winkler B (2011) Anal cancer and cervical cancer screening: key differences. Cancer Cytopathol 119(1):5–19CrossRefPubMed Darragh TM, Winkler B (2011) Anal cancer and cervical cancer screening: key differences. Cancer Cytopathol 119(1):5–19CrossRefPubMed
24.
go back to reference Ortholan C et al (2005) Anal canal carcinoma: early-stage tumors ≤10 mm (T1 or Tis): therapeutic options and original pattern of local failure after radiotherapy. Int J Radiat Oncol Biol Phys 62(2):479–485CrossRefPubMed Ortholan C et al (2005) Anal canal carcinoma: early-stage tumors ≤10 mm (T1 or Tis): therapeutic options and original pattern of local failure after radiotherapy. Int J Radiat Oncol Biol Phys 62(2):479–485CrossRefPubMed
25.
go back to reference American Joint Committee on Cancer (2010) Anus, in AJCC cancer staging handbook. In: Edge SBA (ed) From the AJCC cancer staging manual. Springer, New York, pp 207–218CrossRef American Joint Committee on Cancer (2010) Anus, in AJCC cancer staging handbook. In: Edge SBA (ed) From the AJCC cancer staging manual. Springer, New York, pp 207–218CrossRef
26.
go back to reference Mlakar B (2009) Proctoscopy should be mandatory in men that have sex with men with external anogenital warts. Acta dermatovenerologica Alpina, Pannonica, et Adriatica 18(1):7–11PubMed Mlakar B (2009) Proctoscopy should be mandatory in men that have sex with men with external anogenital warts. Acta dermatovenerologica Alpina, Pannonica, et Adriatica 18(1):7–11PubMed
27.
go back to reference Nyitray AG, Hicks JT, Hwang L-Y, Baraniuk S, White M, Millas S, Onwuka N, Zhang X, Brown EL, Ross MW, Chiao E (in press) A Phase 2 clinical study to assess the feasibility of self- and partner anal exams to detect anal canal abnormalities including anal cancer. Sex Transm Infect Nyitray AG, Hicks JT, Hwang L-Y, Baraniuk S, White M, Millas S, Onwuka N, Zhang X, Brown EL, Ross MW, Chiao E (in press) A Phase 2 clinical study to assess the feasibility of self- and partner anal exams to detect anal canal abnormalities including anal cancer. Sex Transm Infect
28.
go back to reference Ong JJ et al (2016) Cost-effectiveness of screening for anal cancer using regular digital ano-rectal examinations in men who have sex with men living with HIV. J Int AIDS Soc 19(1):20514CrossRefPubMedPubMedCentral Ong JJ et al (2016) Cost-effectiveness of screening for anal cancer using regular digital ano-rectal examinations in men who have sex with men living with HIV. J Int AIDS Soc 19(1):20514CrossRefPubMedPubMedCentral
29.
go back to reference QSR International Pty Ltd., NVivo qualitative data analysis Software. 2012, QSR International Pty Ltd.: Cambridge, MA QSR International Pty Ltd., NVivo qualitative data analysis Software. 2012, QSR International Pty Ltd.: Cambridge, MA
Metadata
Title
A qualitative investigation among men who have sex with men on the acceptability of performing a self- or partner anal exam to screen for anal cancer
Authors
Seyram A. Butame
Sylvia Lawler
Joseph T. Hicks
J. Michael Wilkerson
Lu-Yu Hwang
Sarah Baraniuk
Michael W. Ross
Elizabeth Yu Chiao
Alan G. Nyitray
Publication date
01-10-2017
Publisher
Springer International Publishing
Published in
Cancer Causes & Control / Issue 10/2017
Print ISSN: 0957-5243
Electronic ISSN: 1573-7225
DOI
https://doi.org/10.1007/s10552-017-0935-6

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