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Preliminary findings from the Anal Cancer Examination (ACE) study – acceptability of an annual anal examination amongst patients and doctors

Preliminary findings from the Anal Cancer Examination (ACE) study – acceptability of an annual anal examination amongst patients and doctors

Anal cancer is a common cancer in HIV-positive men who have sex with men (MSM) (incidence ~1 in 1000 per year). No national guidelines exist on the best method to screen for this cancer. The ACE study aims to determine if an annual anal examination (AAE) is cost-effective and acceptable amongst patients and doctors.

Methods: 5 years follow up of 1000 HIV-positive MSM, aged 35 years or older in Victoria. Each participant will undergo an AAE and complete questionnaires at recruitment and after each examination. Questions include quality of life measures, and morbidity associated with the AAE. Participants are recruited from a metropolitan sexual health centre, two high caseload general practices and one HIV outpatients of a major tertiary hospital. Recruitment started in February 2013. A baseline questionnaire for doctors to assess views of anal cancer screening and barriers to implementing an AAE was given to doctors involved in this study.

Results: 211 participants has been recruited with an average age of 52 years and a mean duration of HIV of 13 years. 100% (95% CI 98-100%) of participants stated they would be willing to undergo another anal examination, 5% (95% CI 3-9%) found the examination painful and 0% (95% CI 0-2%) had bleeding. Patients reported being worried they were not clean (67%, 95% CI 61-73%), felt ‘embarrassed’ (30%, 95% CI 24-36%) and worried that they may lose control of their bowels (14%, 95% CI 10-19%). Level of confidence in performing AAE and barriers of implementing AAE in the three clinical settings will be discussed.

Conclusion: The implementation of AAE may be feasible as a screening method for anal cancer in HIV positive MSM with high acceptability amongst patients and doctors in Victoria.

Speakers: Dr Jason Ong
Areas of Interest / Categories: AIDS 2015

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