Provider preferences for anal cancer prevention screening: Results of the International Anal Neoplasia Society survey

IF 4.7 Q1 VIROLOGY

Tumour Virus Research Pub Date : 2022-06-01 DOI:10.1016/j.tvr.2022.200235

Rosalyn E. Plotzker , Gregory M. Barnell , Dorothy J. Wiley , Elizabeth A. Stier , Naomi Jay

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引用次数: 8

Abstract

Objective

This study explores provider preferences regarding anal cancer screening indications, initiation age, tools, and referral threshold to high resolution anoscopy (HRA).

Methods

International Anal Neoplasia Society affiliates were invited to complete an online survey. Options for initiation age and tools were delineated by sub-groups. HRA referral thresholds separately queried recommendations by patient immune status.

Results

One hundred forty respondents participated. Although consensus was lacking with regard to specific screening initiation age, more respondents recommended younger initiation ages for men who have sex with men (MSM) living with HIV (LWH) compared with MSM not LWH (p < 0.01). “No age threshold” ranged 44-55% among sub-groups with lower genital tract disease. Cytology and digital anorectal exam (DARE) were the most frequently selected tools for all sub-groups (ranges 77-90% and 74-86%, respectively). HRA was recommended significantly more frequently for MSM LWH (58%) and patients with vulvar cancer (52%) compared to others (p < 0.01). “Any [test] abnormality” was more often selected as indication for HRA for immunocompromised (56%) and immunocompetent (46%) patients than a specific cytology test result (29%, 36% respectively).

Conclusion

Cytology and DARE were preferred screening tools; screening initiation age and HRA referral threshold showed less consensus. Evidence-based guidelines are needed and may lead to more consistent screening practices.

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提供者对肛门癌预防筛查的偏好:国际肛门肿瘤协会调查的结果

目的:本研究探讨了提供者对肛门癌筛查指征、起始年龄、工具和高分辨率肛门镜检查(HRA)的转诊阈值的偏好。方法邀请国际肛门肿瘤学会附属机构完成在线调查。起始年龄和工具的选择按亚组划分。HRA转诊阈值分别根据患者免疫状态查询推荐。结果共140人参与调查。虽然在具体的筛查起始年龄方面缺乏共识，但更多的受访者建议与男同性恋者(MSM)相比，男同性恋者(LWH)的起始年龄更小(p <0.01)。下生殖道疾病亚组中“无年龄阈值”为44-55%。细胞学检查和直肠指检(DARE)是所有亚组中最常选择的工具(范围分别为77-90%和74-86%)。与其他患者相比，MSM低wh患者(58%)和外阴癌患者(52%)推荐HRA的频率明显更高(p <0.01)。对于免疫功能低下(56%)和免疫功能正常(46%)的患者，“任何[检测]异常”比特定细胞学检查结果(分别为29%和36%)更常被选择作为HRA的指征。结论细胞学和DARE是首选的筛查工具;筛查起始年龄与HRA转诊阈值的一致性较差。需要循证指南，并可能导致更一致的筛查做法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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