TY - JOUR
T1 - Satisfaction with high-resolution anoscopy for anal cancer screening among men who have sex with men
T2 - A cross-sectional survey in Abuja, Nigeria
AU - Nowak, Rebecca G.
AU - Nnaji, Chinedu H.
AU - Dauda, Wuese
AU - Mitchell, Andrew
AU - Olaomi, Oluwole
AU - Jibrin, Paul
AU - Crowell, Trevor A.
AU - Baral, Stefan D.
AU - Ndembi, Nicaise
AU - Charurat, Manhattan E.
AU - Palefsky, Joel M.
AU - Bentzen, Søren M.
AU - Cullen, Kevin J.
AU - Charurat, Manhattan
AU - Ake, Julie
AU - Adebajo, Sylvia
AU - Billings, Erik
AU - Crowell, Trevor
AU - Eluwa, George
AU - Gaydos, Charlotte
AU - Ketende, Sosthenes
AU - Kokogho, Afoke
AU - Liu, Hongjie
AU - Malia, Jennifer
AU - Makanjuola, Olumide
AU - Michael, Nelson
AU - Ndembi, Nicaise
AU - Njab, Jean
AU - Nowak, Rebecca
AU - Olawore, Oluwasolape
AU - Parker, Zahra
AU - Peel, Sheila
AU - Ramadhani, Habib
AU - Robb, Merlin
AU - Rodriguez-Hart, Cristina
AU - Sanders-Buell, Eric
AU - Tovanabutra, Sodsai
AU - Volz, Erik
N1 - Publisher Copyright:
© 2020 The Author(s).
PY - 2020/2/5
Y1 - 2020/2/5
N2 - 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.
AB - 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.
KW - Acceptability
KW - Anal cancer screening
KW - High-resolution anoscopy
KW - LMIC
KW - MSM
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U2 - 10.1186/s12885-020-6567-3
DO - 10.1186/s12885-020-6567-3
M3 - Article
C2 - 32024521
AN - SCOPUS:85079073447
SN - 1471-2407
VL - 20
JO - BMC cancer
JF - BMC cancer
IS - 1
M1 - 98
ER -