Only 11% of HIV-positive gay men in the USA screened for anal cancer
Gay men living with HIV are 37 times more likely to develop anal cancer than HIV-negative gay men, but a lack of guidelines means these men don’t get screened.
Screening for anal cancer in gay men living with HIV in the United States of America (USA) is inadequate, according to data released by the USA Centers for Disease Control (CDC) at the annual IDWeek meeting held in New Orleans in October.
Only 11% of all HIV-positive men who have sex with men (MSM) received anal Pap smears to detect pre-cancerous cells between 2009 and 2012, despite this group being at high-risk of human papillomavirus (HPV) infection, anal dysplasia and anal cancer compared to the general population. Studies have shown that this risk is increasing as antiretroviral treatment means people in this group are living longer.
According to the data, black and Hispanic men were less likely to get screened than white men. Younger men under 40 were also less likely to get screened than older men. Despite smoking increasing the risk of developing HPV, smokers in these groups were also less likely to get screened.
There are currently no guidelines in place in the USA to screen men for anal cancer. Similar guidelines have been implemented to screen for HPV in women – a major pre-indicator of cervical cancer – and mortality and morbidity has decreased as a result.
Demetre Daskalakis, MD of the New York City Department of Health and Mental Hygiene said: “Building high resolution anoscopy infrastructure and supporting screening with national guidelines may change the tide of this trend in HIV-positive MSM, as cervical Pap smears did with cervical cancer."