TAILIEUCHUNG - Anal Cancer: In Gay and Bisexual Men

The efficacy of a screen-and-treat program is influenced not only by accuracy of the screening test but also by the ability of the treatment, in this case cryotherapy, to eliminate CIN2+ lesions identified by screening. While cryotherapy was highly successful in this trial, eliminating 75 to 77 percent of CIN2+ lesions, this was lower than previously reported 85 to 90 percent cure rates for clinical trials in developed countries and for less rigorous studies in developing regions. 1 The authors noted that in their South Africa trial, women underwent four separate examinations and that this rigorous assessment may explain the (more. | Science to Community Anal Cancer In Gay and Bisexual Men Clinical 3 Research Team Joel Palefsky MD Elizabeth Holly PhD Naomi Jay RN NP Michael Berry MD Ross Cranston MD Joe Thatcher RN Tere Darragh MD Mary Ralston PhD Ruth Greenblatt MD Mark Welton MD University of California San Francisco and Sue Goldie MD at Harvard University of California San Francisco Introduction Anal cancer is a serious and pervasive health problem among and gay and bisexual men. Before the onset of the AIDS epidemic the incidence of anal cancer among men with a history of receptive anal intercourse has been estimated at about 35 per 100 000. This is about the same incidence as that for cervical cancer prior to the implementation of broad screening programs promoting early detection and treatment among at-risk women. As with many cancers the exact causes of anal cancer are not clearly understood. However there is general scientific consensus that human papillomavirus HPV is at least partly to blame. HPV is a sexually transmitted infection found in many different types in different parts of the body. Infection with HPV is common with one large study at UCSF detecting HPV in 61 of HIVnegative and 93 of HIV-positive of gay and bisexual men. Typically infection is with not one but several different types of HPV. In this same study 23 of HIV-negative and 61 of HIVpositive men were infected with multiple HPV types. Several studies have suggested that having multiple types of HPV increases risk of progression to cancer. The evidence for an association between HPV and anal cancer is strong. Similar to cervical cancer the DNA for HPV is often detected in anal cancer tissues. The types of HPV detected are also those known to cause cancer. Conversely anal cancer is rarely found without finding some type of HPV also present. Anal Squamous Intraepithelial Lesions Infection with HPV does not automatically result in the development of cancer it may in fact result in no disease at all. Some people develop .

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