855. Anal Cancer Screening in Men who have sex with Men in Care for HIV infection, United States, 2009-2012
Session: Oral Abstract Session: HIV Co-Morbidities and Co-Infections
Thursday, October 27, 2016: 3:15 PM
Room: 275-277
Background:  Anal cancer is a common cancer among HIV-infected men who have sex with men (MSM) and studies have suggested an increasing incidence in this population. To date, there are no national guidelines recommending anal cancer screening and no population-based estimates of screening rates among HIV-infected MSM. Understanding current practices could inform discussions about the appropriate standard of care.

Methods:  The 2009-2012 Medical Monitoring Project (MMP) conducted interviews and medical record abstraction for a representative sample of HIV-infected adults in care in the United States. Using weighted MMP data collected from 6/2009-5/2012, we describe the characteristics of HIV-infected MSM with medical record documentation of anal cancer screening in the 12 months before interview (n=914) and used Rao-Scott χ2 tests to compare their demographics, clinical status, behaviors, and facility characteristics to MSM not screened for anal cancer (n=7515).

Results: 

An estimated 11% (95% confidence interval [CI] 9-13) of HIV-infected MSM were screened for anal cancer in the past 12 months. White MSM were more likely to be screened than black MSM (13% [CI 9-16] vs. 7% [CI 6-9]). Other factors that were significantly associated with screening included: having at least 1 viral load test in each 6 month period in the past year vs. not (12% [CI 10-15] vs. 9% [CI 7-10]), > high school vs. < high school education (12% [CI 10-14] vs. 9% [CI 6-11]), non-smoker vs. smoker (12% [CI 10-14] vs. 10% [CI 8-12]), anal sex vs. no anal sex in the past year (12% [CI 10-14] vs. 10% [CI 8-12]), and attending a facility providing HIV care for >400 vs. <400 patients [14% (CI 11-16) vs. 4 % (CI 2-6)]. 

Conclusion:  There are no federal guidelines for anal cancer screening in HIV-infected men. However, between 2009 and 2012, only 11% of HIV-infected MSM in care were screened for anal cancer, and significant disparities in screening by various characteristics were observed. Guidelines for cervical cancer screening have reduced morbidity and mortality from cervical cancer in HIV-infected women. As MMP is an ongoing surveillance system, the estimates presented here could inform decision making around adoption of screening guidelines and be used to monitor disparities in screening rates among HIV-infected MSM.

Mark Freedman, DVM, MPH, John Weiser, MD, MPH, Linda R. Beer, PhD and R. Luke Shouse, MD, MPH, Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA

Disclosures:

M. Freedman, None

J. Weiser, None

L. R. Beer, None

R. L. Shouse, None

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