Awareness and knowledge of anal cancer in a community-recruited sample targeting people with HIV and gay/bisexual men

Abstract

Background: Anal cancer disproportionately affects gay and bisexual men (GBM), especially those with HIV infection. We explored the awareness and understanding of human papillomavirus (HPV) and anal cancer in a community-based cohort, to inform future evidence-based public health interventions. Methods: Participants recruited through advertisements at gay and HIV community organisations completed an anonymous online questionnaire that assessed knowledge, understanding and experience of anal HPV, HPV vaccination, anal cancer screening and perceived personal risk of anal cancer. Results: Of 1660 questionnaires returned, 1535 (92.5%) were from GBM, of whom the majority thought their risk of anal cancer was the same, or lower, than that of the general population. 196 (13.5%) participants reported ever having talked to their doctor about anal HPV and/or anal cancer. The discussion was initiated by the patient in more than half (58.7%) of cases, but was more likely to be doctor-initiated by participants who were HIV positive than negative/unknown (51.6% vs 35.7%, p=0.037). Only a small minority (12.7%) had talked to their doctor about anal HPV and/or anal cancer and (11.8%) had an anal cancer examination. Less than one third (32.3%) had heard of HPV vaccination and only 3.0% of men aged ≤ 26 years had received HPV vaccination. Conclusions: Knowledge and awareness of anal cancer was generally very poor in GBM, who are at elevated risk of anal cancer. Specific information targeted at this group could potentially raise awareness, leading to earlier diagnosis and improved outcomes. Young GBM need education around the importance of HPV vaccination.