A study found that in spite of efforts in recent years to raise human papillomavirus (HPV) and anal cancer awareness, groups most at risk appear to remain uncertain of risk, screening, and measures to protect themselves from the adverse implications of HPV infection.
Writing in “HPV and Anal Cancer Knowledge Among HIV-Infected and Non-Infected Men Who Have Sex with Men” in LGBT Health, Eric A. Fenkl, PhD; Sandra Gracia Jones, PhD; Elie Schochet, MD; and Paulette Johnson, PhD investigated the current status of what men who have sex with men (MSM) know about anal cancer in terms of self-care behaviors/practices, HPV knowledge, risk awareness, anal cancer screening history, the need to be screened, and how demographic or behavioral practices were associated with knowledge and awareness.
One hundred and sixty-three participants were recruited in 2014–2015 in venues such as Pride Center events as well as in bars, restaurants, and cafes that cater to a gay clientele. Participants’ knowledge of HPV and anal cancer were examined using the Anal Cancer Knowledge Questionnaire (ACKQ). The 65-item survey consisted of demographic variables, questions related to anal health behaviors, practices, and perceptions, HPV and anal cancer knowledge, and HPV and anal cancer risk awareness.
The study found that “to a great extent, the participants were uninformed and largely unaware of the link between HPV and anal cancer and the risk that HPV and anal cancer presented to MSM.”
One-way analysis of variance (ANOVA) indicated that HPV knowledge, P < .001, and risk awareness, P < .001, differed by HIV status.
“In spite of… knowledge-deficit findings as well as efforts in recent years to raise HPV and anal cancer awareness, the public and those groups most at risk appear to remain uncertain of risk, screening, and measures to protect themselves from the adverse implications of HPV infection. This means that there is much to be done from a health care provider perspective, as the impending crisis of HPV-related anal cancer among gay men continues to grow,” the study noted.
Although the Centers for Disease Control and Prevention (CDC) has not recommended routine anal Pap test screening for anyone or any sub-group, it does state that “because of the increased incidence of anal cancer in HIV-infected MSM, screening for anal cytologic abnormalities can be considered and might become a useful preventive measure.”
The study similarly noted that a discussion on HPV and anal cancer would not be complete without addressing the issue of stigma.
“Although not a component of this particular study, it can be argued that cancer itself is stigmatized in general and even more so for members of the lesbian, gay, bisexual, and transgender (LGBT) community. In addition to being diagnosed with an illness that others cannot readily see or understand, the patient is often confronted with the notion of perhaps having done something to get cancer, such as living an unhealthy lifestyle or having engaged in unhealthy choices and habits. This stigma is increased when it involves a personal area such as the anus.”
According to the authors, this study highlighted that “there is much to be done from a health care provider perspective, as the impending crisis of HPV-related anal cancer among gay men continues to grow.”
