The purpose of this research is to show the prevalence of anal Pap smear abnormalities and follow-up activities among MSM patients receiving HIV care at the ECU Infectious Diseases and International Travel Health Clinic (ECU ID).
Background: Squamous cell carcinoma of the anus (i.e. anal cancer), represents 0.5% of all new cancer cases in the US in 2017 according to the National Cancer InstituteÕs Surveillance, Epidemiology, and End Results Program. Literature shows that the HIV-infected men who have sex with men (MSM) population is 52 times more likely to develop anal cancer compared to the non-HIV-infected population. Anal Pap screenings have potential to detect the presence of anal cancer earlier, but no national guidelines exist for performing anal Papanicolaou (Pap) screens among MSM.
Methods: A retrospective chart review was performed on 505 qualifying patients. Baseline data about anal Pap screening and follow-up rates were gathered. Data were collected from January 1st, 2016 to May 31st, 2017.
Results: Anal Pap smear abnormality findings: Atypical Squamous cells of Undetermined Significance (ASCUS), Low Grade Squamous Intraepithelial Lesion (LGSIL), High Grade Squamous Intraepithelial Lesion (HGSIL).
Conclusion: Our results indicate variation in practice among providers at ECU ID Clinic regarding the screening, the need for a follow-up, and the type of follow-up provided. Additionally, research shows that anal cancer is one of the non-defining AIDS cancers whose incidence increases as the patient ages. However, based on the data, anal cancer screening decreases as the patient ages at the ECU ID clinic. Therefore, a standardized clinic protocol is needed, which may help improve the screening and follow-up rates. Also, a higher percentage of patients with an ASCUS result do not receive follow-up when compared to patients with a LGSIL and HGSIL result. Future research to determine the significance of follow-up for patients with an ASCUS result should be explored.
N. Fadul, None