Open AccessEnvironmental scan of anal cancer screening practices: worldwide survey results
Author(s) -
Patel Jigisha,
Salit Irving E.,
Berry Michael J.,
Pokomandy Alexandra,
Nathan Mayura,
Fishman Fred,
Palefsky Joel,
Tinmouth Jill
Publication year - 2014
Publication title -
cancer medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.403
H-Index - 53
ISSN - 2045-7634
DOI - 10.1002/cam4.250
Subject(s) - anal cancer , medicine , family medicine , population , cancer screening , asymptomatic , health care , cancer , gynecology , human immunodeficiency virus (hiv) , environmental health , economics , economic growth
Anal squamous cell carcinoma is rare in the general population but certain populations, such as persons with HIV , are at increased risk. High‐risk populations can be screened for anal cancer using strategies similar to those used for cervical cancer. However, little is known about the use of such screening practices across jurisdictions. Data were collected using an online survey. Health care professionals currently providing anal cancer screening services were invited to complete the survey via email and/or fax. Information was collected on populations screened, services and treatments offered, and personnel. Over 300 invitations were sent; 82 providers from 80 clinics around the world completed the survey. Fourteen clinics have each examined more than 1000 patients. Over a third of clinics do not restrict access to screening; in the rest, eligibility is most commonly based on HIV status and abnormal anal cytology results. Fifty‐three percent of clinics require abnormal anal cytology prior to performing high‐resolution anoscopy ( HRA ) in asymptomatic patients. Almost all clinics offer both anal cytology and HRA . Internal high‐grade anal intraepithelial neoplasia ( AIN ) is most often treated with infrared coagulation (61%), whereas external high‐grade AIN is most commonly treated with imiquimod (49%). Most procedures are performed by physicians, followed by nurse practitioners. Our study is the first description of global anal cancer screening practices. Our findings may be used to inform practice and health policy in jurisdictions considering anal cancer screening.