Just as use of Pap smears has led to a dramatic drop in cervical cancer, so screening for anal cancer among HIV-positive gay and bisexual men would save many lives at a reasonable cost, according to a new study published in the Journal of the American Medical Association (JAMA).
The study predicts that use of a simple and inexpensive procedure, comparable to a Pap smear, would lead to both early detection of pre-cancerous lesions among high-risk men and allow for early treatment of a type of cancer known as anal squamous cell cancer.
About 35 HIV-negative gay men per 100,000 develop this form of anal cancer every year, according to available statistics. Among HIV-positive gay men, the rate is estimated to be about twice as high.
By comparison, about 40 women per 100,000 contracted cervical cancer every year in the U.S. before the Pap smear was in widespread use. Today, only about eight women per 100,000 get cervical cancer. The hope is that a simple, early screening procedure for anal squamous cell cancer would lead to a similar drop in disease and death.
"Unlike other cancers in HIV-positive men, this cancer is potentially preventable," says Joel Palefsky, M.D., professor of laboratory medicine at the University of California San Francisco and senior author of the JAMA paper. No one knew that cervical cancer was preventable before the use of Pap smears as a screening aid became widespread in the 1960s, Palefsky adds.
Leader of the study and first author on the JAMA paper is Sue J. Goldie, M.D., M.P.H., assistant professor of health policy and decision science in the Department of Health Policy and Management at Harvard School of Public Health.
The new study draws on scientific information gained from cervical cancer screening and is based on epidemiological data from large samples of at-risk men in San Francisco and Seattle.
The researchers predict that annual anal Pap smear screenings, along with
follow-up biopsies and surgeries f
Contact: Wallace Ravven
University of California - San Francisco