Anal cancer screening knowledge, attitudes, and experiences among men who have sex with men in Ottawa, Ontario

Abstract

Anal cancer is rare; however, men who have sex with men (MSM) are at significantly increased risk compared to the general population. In Canada, no widespread screening programs nor accepted standards of care exist to inform primary care physicians (PCP) regarding screening and prevention for MSM patients. Our objective was to assess the knowledge, attitudes and experience of a sample of MSM regarding anal cancer risk, screening, prevention, and acceptability of HPV vaccination. A cross-sectional survey was conducted at an STI clinic for MSM in Ottawa, Ontario over a 20-week period. Descriptive statistics, Pearson's Chi-square test and binary logistic regression for comparisons between groups were completed. Fifty-five percent of respondents were aware of increased anal cancer risk among MSM; 47.7% were aware that HPV is the primary cause. Only 14.8% of men with a PCP had discussed anal cancer screening and prevention with their PCP. Of those who had not, 86.0% indicated they would be comfortable having that discussion. Just under 8% reported receiving an appropriate screening test. The HPV vaccination rate was 16.2%. The majority of respondents who had not been vaccinated expressed openness to vaccination. A clear deficiency was observed in terms of MSM knowledge regarding anal cancer risk and inclusion of this health concern in their primary care. This highlights the need for more discussion between MSM and their PCPs to ensure MSM are aware of their risk and of available screening and prevention options recognizing the limited evidence-base for anal cancer screening.