2274. Assessment of Anal Papanicolaou Smear Screening and Follow-up Rates in Eastern North Carolina for HIV-Positive Patients Who Are Men Who Have Sex With Men

Abstract

The purpose of this research is to show the prevalence of anal Pap smear abnormalities and follow-up activities among MSM patients receiving HIV care at the ECU Infectious Diseases and International Travel Health Clinic (ECU ID).BackgroundSquamous cell carcinoma of the anus (i.e. anal cancer), represents 0.5% of all new cancer cases in the United States in 2017 according to the National Cancer Institute’s Surveillance, Epidemiology, and End Results Program. Literature shows that the HIV-infected men who have sex with men (MSM) population is 52 times more likely to develop anal cancer compared with the non-HIV-infected population. Anal Pap screenings have the potential to detect the presence of anal cancer earlier, but no national guidelines exist for performing anal Papanicolaou (Pap) screens among MSM.MethodsA retrospective chart review was performed on 505 qualifying patients. Baseline data about anal Pap screening and follow-up rates were gathered. Data were collected from January 1st, 2016 to May 31st, 2017.ResultsAnal Pap smear abnormality findings: Atypical Squamous cells of Undetermined Significance (ASCUS), Low Grade Squamous Intraepithelial Lesion (LGSIL), High Grade Squamous Intraepithelial Lesion (HGSIL). ConclusionOur results indicate variation in practice among providers at ECU ID Clinic regarding the screening, the need for a follow-up, and the type of follow-up provided. Additionally, research shows that anal cancer is one of the non-defining AIDS cancers whose incidence increases as the patient ages. However, based on the data, anal cancer screening decreases as the patient ages at the ECU ID clinic. Therefore, a standardized clinic protocol is needed, which may help improve the screening and follow-up rates. Also, a higher percentage of patients with an ASCUS result do not receive follow-up when compared with patients with an LGSIL and HGSIL result. Future research to determine the significance of follow-up for patients with an ASCUS result should be explored.Disclosures All authors: No reported disclosures.