Psychological and utility-based quality of life impact of screening test results for anal precancerous lesions in gay and bisexual men: baseline findings from the Study of the Prevention of Anal Cancer. (1st August 2019)

• Record Type: Journal Article
• Authors: Cvejic, Erin; Poynten, Isobel Mary; Kelly, Patrick J; Jin, Fengyi; Howard, Kirsten; Grulich, Andrew E; Templeton, David J; Hillman, Richard J; Law, Carmella; Roberts, Jennifer M; McCaffery, Kirsten
• Other Names: author non-byline.; Acraman Brian author non-byline.; Carr Andrew author non-byline.; Carroll Susan author non-byline.; Cooper David author non-byline.; Cornall Alyssa author non-byline.; Crampton Leonie author non-byline.; Fairley Christopher author non-byline.; Farnsworth Annabelle author non-byline.; Feeney Lance author non-byline.; Fraissard Eddie author non-byline.; Garland Suzanne author non-byline.; Grulich Andrew author non-byline.; Hillman Richard author non-byline.; Howard Kirsten author non-byline.; Jin Fengyi author non-byline.; Law Carmella author non-byline.; Law Matthew author non-byline.; McCaffery Kirsten author non-byline.; McGrath Patrick author non-byline.; Mellor Robert author non-byline.; O'Dwyer Matthew author non-byline.; Petoumenos Kathy author non-byline.; Pezzopane Piero author non-byline.; Phillips Samuel author non-byline.; Poynten Isobel Mary author non-byline.; Prestage Garrett author non-byline.; Richards Adele author non-byline.; Roberts Jennifer author non-byline.; Seeds Daniel author non-byline.; Tabrizi Sepehr author non-byline.; Templeton Dave author non-byline.; Thurloe Julia author non-byline.; Tong Winnie author non-byline.; Varma Rick author non-byline.;
• Is Part Of: Sexually transmitted infections. Volume 96:issue 3(2020)
• Page Start: 177
• Page End: 183
• Publication Date: 2019-08-01
• Subjects: anal squamous cell carcinoma -- anxiety -- cancer screening -- gay and bisexual men (GBM) -- human immunodeficiency virus (HIV) -- human papillomavirus (HPV) -- psychological impact -- quality of life; Sexually transmitted diseases -- Periodicals; HIV infections -- Periodicals; 616.951005
• DOI: 10.1136/sextrans-2019-054098
• Languages: English
• ISSNs: 1368-4973

Abstract

Abstract : Objective: Gay, bisexual and other men who have sex with men (GBMSM), particularly HIV-positive GBMSM, are at increased anal cancer risk compared with the general population. This study examined the psychological and quality of life (QoL) impact of receiving abnormal anal cancer screening results during the baseline visit of the Study of the Prevention of Anal Cancer (SPANC). Methods: SPANC was a prospective cohort study of the natural history of anal human papillomavirus (HPV) and associated abnormalities in GBM aged 35 years and over. Participants completed questionnaires including aspects of health-related QoL (HR-QoL) and psychosocial functioning at baseline. Participants underwent procedures including an anal swab for cytology, and high-resolution anoscopy with biopsy of any possibly HPV-related abnormality. Questionnaires were readministered 2 weeks and 3 months after participants were given cytology and histology results. Perceived test result served as the study factor. Results: Participants with perceived abnormal results (n=232) reported poorer HR-QoL (mean difference=1.8; p=0.004) and lower utility-based QoL (mean difference=0.02; p=0.018) 2 weeks after screening than individuals with perceived normal results (n=268). These differences did not persist at 3-month follow-up. A greater proportion of participants who perceived their results as abnormal reported feeling worse than usual about their anal health and anal cancer fear (p's<0.001), experienced more intrusive thoughts about their results (p's≤0.006) and felt more likely to develop cancer than other gay men their age (p's≤0.025) at both time points than those with perceived normal results. Conclusions: Providing abnormal results may cause psychological distress and impact HR-QoL, with sustained intrusive thoughts, increased cancer worry and perceived cancer risk. The potential for psychological harm needs to be considered when implementing anal cancer screening programmes.