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dc.contributor.authorNowak, R.G.
dc.contributor.authorBentzen, S.M.
dc.contributor.authorBlattner, W.A.
dc.contributor.authorCharurat
dc.contributor.authorM.E.
dc.contributor.authorCullen, K.J.
dc.date.accessioned2019-08-16T13:45:22Z
dc.date.available2019-08-16T13:45:22Z
dc.date.issued2019
dc.identifier.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85069934611&doi=10.1200%2fJGO.19.00102&partnerID=40&md5=d83f452d39c68ae96648d5845d7f3495
dc.identifier.urihttp://hdl.handle.net/10713/10354
dc.description.abstractPURPOSE Anal cancer risk is substantially higher among HIV-infected men who have sex with men (MSM) as compared with other reproductive-age adults, but screening is rare across sub-Saharan Africa. We report the use of high-resolution anoscopy (HRA) as a first-line screening tool and the resulting early outcomes among MSM in Abuja, Nigeria. METHODS From August 2016 to August 2017, 424 MSM enrolled in an anal cancer screening substudy of TRUST/RV368, a combined HIV prevention and treatment cohort. HRA-directed biopsies were diagnosed by histology, and ablative treatment was offered for high-grade squamous intraepithelial lesions (HSIL). HRA proficiency was assessed by evaluating the detection of squamous intraepithelial lesions (SIL) over time and the proportion biopsied. Prevalence estimates of low-grade squamous intraepithelial lesions and HSIL with 95% CIs were calculated. Multinomial logistic regression was used to identify those at the highest risk of SIL. RESULTS Median age was 25 years (interquartile range [IQR], 22-29), median time since sexual debut was 8 years (IQR, 4-12), and 59% (95% CI, 54.2% to 63.6%) were HIV infected. Rate of detection of any SIL stabilized after 200 screenings, and less than 20% had two or more biopsies. Preliminary prevalence estimates of low-grade squamous intraepithelial lesions and HSIL were 50.0% (95% CI, 44.7% to 55.3%) and 6.3% (95% CI, 4.0% to 9.3%). HIV infection, at least 8 years since anal coital debut, concurrency, and external warts were independently statistically associated with SIL. CONCLUSION Proficiency with HRA increased with experience over time. However, HSIL detection rates were low, potentially affected by obstructed views from internal warts and low biopsy rates, highlighting the need for ongoing evaluation and mentoring to validate this finding. HRA is a feasible first-line screening tool at an MSM-friendly health care facility. Years since anal coital debut and external warts could prioritize screening.en_US
dc.description.sponsorshipen_US
dc.description.urihttps://www.doi.org/10.1200/JGO.19.00102en_US
dc.language.isoen-USen_US
dc.publisherAmerican Society of Clinical Oncologyen_US
dc.relation.ispartofJournal of Global Oncology
dc.subject.lcshAnus--Canceren_US
dc.subject.meshHomosexuality, Maleen_US
dc.subject.meshEarly Detection of Canceren_US
dc.subject.meshNigeriaen_US
dc.titleImplementation of and early outcomes from anal cancer screening at a community-engaged health care facility providing care to Nigerian men who have sex with menen_US
dc.typeArticleen_US
dc.identifier.doi10.1200/JGO.19.00102


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