Mount Sinai West, Icahn School of Medicine at Mount Sinai New York, NY
Patricia Miguez Arosemena, MD1, Emily Seltzer, DO, MS1, Allison Wang, MD1, Cristina Olivo Freites, MD2, Sophia Nurani, ANP3, Kayla Leschly, 3, Jayme Leschly, 3, Christian Olivo Freites, MD3, John A. Andrilli, MD4, Frank Nelson, MD1 1Mount Sinai West, Icahn School of Medicine at Mount Sinai, New York, NY; 2University of Texas at Houston, Houston, TX; 3Ryan Chelsea-Clinton Community Health Center, New York, NY; 4Mount Sinai Morningside, Icahn School of Medicine at Mount Sinai, New York, NY
Introduction: Until January 2024, proper guidelines for anal cancer screening were lacking, leaving a significant gap in preventive care for high-risk populations. The International Anal Neoplasia Society recommends annual anal Pap smears for HIV-positive men who have sex with men (MSM) and are 35 years or older. This study explores patient and provider perspectives on anal cancer screening, highlighting barriers for screening, and assessing provider comfort levels in performing the anal Pap smears.
Methods: We contacted all 14 HIV care providers in our practice via email, inviting them to complete an anonymous survey. Additionally, we surveyed 44 HIV-positive MSM over the age of 35 during clinic visits. Data collected from the surveys were analyzed using descriptive statistics.
Results:
The survey response rate among providers was 78.6%, with 54.6% over 40 years old (mean age 43.1 years) and 72.7% female. Only 45.6% had over 10 years of practice experience. Key barriers to screening included lack of time during patient visits (81.8%), insufficient training in performing anal Pap smears (45.5%), and patients declining due to time constraints (45.5%). Only 36.4% of providers felt very comfortable performing anal Pap smears, and 63.7% discussed anal cancer screening with patients every 6 months to a year.
All patients approached completed the survey. Most (77.3%) had heard of anal cancer screening, 63.3% had been offered appropriate testing in the past. Of those offered screening, 85.7% completed the test and 91.7% planned to repeat it annually. The overall screening rate was 54.5%. Among patients who had never been offered testing, 62.5% expressed interest in getting screened.
Discussion:
This study highlights significant barriers to anal cancer screening. While most patients were aware of screening, actual testing rates remain low. Providers face challenges such as time constraints, insufficient training, and low comfort levels in performing anal Pap smears. Improving these barriers could enhance screening uptake. Focusing on patient education and access to screenings may further improve compliance with annual screening recommendations, ultimately advancing preventive care for this high-risk population.
References:
1. Stier EA, et al. International Anal Neoplasia Society's consensus guidelines for anal cancer screening. Int J Cancer. 2024;154(10):1694-1702.
Note: The table for this abstract can be viewed in the ePoster Gallery section of the ACG 2024 ePoster Site or in The American Journal of Gastroenterology's abstract supplement issue, both of which will be available starting October 27, 2024.
Disclosures:
Patricia Miguez Arosemena indicated no relevant financial relationships.
Emily Seltzer indicated no relevant financial relationships.
Allison Wang indicated no relevant financial relationships.
Cristina Olivo Freites indicated no relevant financial relationships.
Sophia Nurani indicated no relevant financial relationships.
Kayla Leschly indicated no relevant financial relationships.
Jayme Leschly indicated no relevant financial relationships.
Christian Olivo Freites indicated no relevant financial relationships.
John Andrilli indicated no relevant financial relationships.
Frank Nelson indicated no relevant financial relationships.
Patricia Miguez Arosemena, MD1, Emily Seltzer, DO, MS1, Allison Wang, MD1, Cristina Olivo Freites, MD2, Sophia Nurani, ANP3, Kayla Leschly, 3, Jayme Leschly, 3, Christian Olivo Freites, MD3, John A. Andrilli, MD4, Frank Nelson, MD1. P3642 - Patient and Provider Perspective on Anal Cancer Screening in a Federally Qualified Health Center, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.
