Satisfaction with high-resolution anoscopy for anal cancer screening among men who have sex with men: a cross-sectional survey in Abuja, Nigeria

Year: 2020

Type: article

Abstract: BACKGROUND: Men who have sex with men (MSM) living with HIV are at increased risk for anal cancer. We evaluated satisfaction with first-time anal cancer screening using high resolution anoscopy (HRA) as a cross sectional survey among men who have sex with men (MSM) attending a community-engaged clinic in Abuja, Nigeria. METHODS: Between March and August 2017, 342 MSM underwent screening and 307 (89%) completed a satisfaction survey that evaluated 8 domains related to expectations, convenience, staff interpersonal skills, physical surroundings, technical competence, pain/discomfort, general satisfaction, and intention to re-screen if symptomatic. The 22-item questionnaire used 5-point Likert scales ranging from 1 (strongly disagree) to 5 (strongly agree). For each domain, responses to specific items were averaged, aggregated, and converted to a 100-point scaled score (SS) with 25 and 75 corresponding to disagree and agree, respectively. RESULTS: Median age was 24 years (interquartile range [IQR]: 22-28), median years since anal coital debut was 7 (IQR: 4-12), and 58% (95% confidence interval [CI]: 52-64%) were living with HIV. Despite respondents reporting pre-procedure anxiety (SS:73), most were comfortable with the setting and procedure and reported overall satisfaction (SS:74-76). Willingness to undergo future screening had the lowest score (SS:69) within the general satisfaction domain. The lowest scoring domains were pain/discomfort (SS:57) and agreement to re-screen if symptomatic (SS:59), which correlated with lower overall satisfaction (p < 0.001). Domain responses did not differ by HIV infection after adjusting for multiple comparisons (p > 0.006) or number of anal biopsies (all p > 0.05). CONCLUSIONS: Overall, HRA was satisfactory for those naïve to screening but moving forward necessitates monitoring levels of discomfort with pain scales and normalizing dialogue around clinical symptoms of anal cancer and overall anal health to sustain future screening.

Source: BMC Cancer

DOI: 10.1186/s12885-020-6567-3

Authors: on behalf of the TRUST/RV368 Study Group, Rebecca G. Nowak, Chinedu H. Nnaji, Wuese Dauda, Andrew Mitchell, Oluwole Olaomi, Paul Jibrin, Trevor A. Crowell, Stefan D. Baral, Nicaise Ndembi, Manhattan E. Charurat, Joel M. Palefsky, Søren M. Bentzen, Kevin J. Cullen

Institutions: University of Maryland, Baltimore, Institute of Human Virology, University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, National Hospital Abuja, Walter Reed Army Institute of Research, Henry M. Jackson Foundation, Johns Hopkins University, University of California, San Francisco

Language: English

Topic: Colorectal and Anal Carcinomas

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,390

Funders: U.S. Department of Defense, Foundation for the National Institutes of Health, U.S. Department of Health and Human Services, Henry M. Jackson Foundation, Johns Hopkins University, U.S. President’s Emergency Plan for AIDS Relief, Imperial College London, National Institutes of Health, Centers for Disease Control and Prevention, Johns Hopkins Bloomberg School of Public Health, University of Maryland School of Public Health, National Institute of Mental Health, National Cancer Institute, National Institute of Allergy and Infectious Diseases, Fogarty International Center, U.S. Military HIV Research Program, Walter Reed Army Institute of Research

OpenAlex ID: W3008016161