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Exploring anal self-examination as a screening tool for women at risk for anal cancer: awareness, interest, and barriers to behavioral uptake

Authors
  • Moskowitz, David A.1, 2
  • Rahman, Musarrat3
  • Li, Dennis H.1, 2
  • 1 Feinberg School of Medicine, Northwestern University, Department of Medical Social Sciences, 633 N. St. Clair St., Chicago, IL, 60611, USA , Chicago (United States)
  • 2 Feinberg School of Medicine, Northwestern University, Institute for Sexual and Gender Minority Health and Wellbeing (ISGMH), 625 N. Michigan Avenue, Suite 1400, Chicago, IL, 60611, USA , Chicago (United States)
  • 3 School of Health Sciences & Practice, New York Medical College, Department of Public Health, Valhalla, NY, USA , Valhalla (United States)
Type
Published Article
Journal
Cancer Causes & Control
Publisher
Springer-Verlag
Publication Date
Apr 29, 2019
Volume
30
Issue
6
Pages
559–568
Identifiers
DOI: 10.1007/s10552-019-01175-1
Source
Springer Nature
Keywords
License
Yellow

Abstract

PurposeAnal cancer is the second most common human-papillomavirus-related cancer in women, with women also at an elevated risk of incidence relative to men. Anal self-examination (ASE) is an efficient way for women to screen between provider visits for potential anal masses. While studied in male populations, no research has explored women’s awareness of the self-test.MethodsIn response, 345 women recruited from online advertisements and listservs were surveyed to assess their experiences using health care, history of Pap smears, knowledge of anal cancer, awareness and attitudes surrounding ASEs, and potential educational modalities to promote ASE enactment.ResultsResults indicated the sample failed two key anal cancer knowledge tests (receiving a 68%/100% for risk factors and 61%/100% for signs/symptoms), and only 2.3% of participants had ever heard of ASEs before the survey. Most thought ASEs would be somewhat helpful as a screening tool, but little interest was shown towards future performance. Analyses revealed this disinterest was due to lack of knowledge, perceived discomfort with performing ASEs, and perceived irrelevance of ASEs.ConclusionsFuture interventions should push for a stronger role of providers (e.g., gynecologists) in anal health, education, and screening. Additionally, campaigns should be crafted to promote the ASE as an easy, at-home screening tool that could trigger an early warning for anal disease.

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