ArticleLancet regional health. Americas2024
The accuracy of anal self- and companion exams among sexual minority men and transgender women: a prospective analysis.
Article in Lancet regional health. Americas, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.
- Barriers and facilitators to anal cancer screening among men who have sex with men: a systematic review with narrative synthesis.BMC cancer · 2025Pooled it
- Barriers and Facilitators to HPV Vaccination Completion among Transgender Women in Mexico: Implications for HPV Prevention and Education.Journal of cancer education : the official journal of the American Association for Cancer Education · 2026Article
- The longitudinal effect of repetition and practice on the accuracy of lay anal examinations for detecting perianal and anal canal abnormalities: a prospective study.Lancet regional health. Americas · 2026Article
- Impact and Cost-effectiveness of Regular Self-digital Anorectal Examination on Syphilis Among Gay, Bisexual, and Other Men Who Have Sex With Men: A Mathematical Modeling Study.The Journal of infectious diseases · 2025Article
- Dyadic Interventions for LGBTQ+ Individuals Facing Cancer: A Narrative Review.Current treatment options in oncology · 2025Review
- Anal self-exam is a valuable screening tool for anal cancer in sexual and gender minority persons.Lancet regional health. Americas · 2024Article
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15 authors at 6 institutions in 1 country.
Funding
Abstract
Background: Squamous cell carcinoma of the anus (SCCA) annual incidence among sexual minority men with and without HIV is 85/100,000 and 19/100,000 persons, respectively, which is significantly higher than the overall incidence (2/100,000). Incidence may also be higher in transgender women. Since SCCA tumours average ≥30 mm at diagnosis, we assessed the accuracy of individuals to self-detect smaller anal abnormalities. Methods: Using convenience sampling, the study enrolled sexual minority men and transgender women, aged 25-81 years, in Chicago, Illinois and Houston, Texas, USA, during 2020-2022. Individuals were taught the anal self-examination and anal companion examination (ASE/ACE). Then, a clinician performed a digital anal rectal examination (DARE) before participants conducted the ASE or ACE. The sensitivity, specificity and concordance of the ASE/ACE to detect an abnormality were measured along with factors associated with ASE/ACE and DARE concordance. Findings: Among 714 enrolled individuals, the median age was 40 years (interquartile range, 32-54), 36.8% (259/703) were living with HIV, and 47.0% (334/710), 23.4% (166/710), and 23.0% (163/710) were non-Hispanic white, non-Hispanic Black, and Hispanic, respectively. A total of 94.1% (671/713) identified as cisgendered men, and 5.9% (42/713) as gender minorities. A total of 658 participants completed an ASE and 28 couples (56 partners) completed an ACE. Clinicians detected abnormalities in 34.3% (245/714) of individuals. The abnormalities were a median of 3 mm in diameter. Sensitivity and specificity of the ASE/ACE was 59.6% (95% CI 53.5-65.7%) and 80.2% (95% CI 76.6-83.8%), respectively. Overall concordance was 0.73 (95% CI 0.70-0.76) between ASE/ACE and DARE and increased with increasing anal canal lesion size (p = 0.02). Concordance was lower when participants were older and received ASE/ACE training from a lay person rather than a clinician. Interpretation: Sexual minority men/transgender women may self-detect SCCA when malignant lesions are much smaller than the current mean dimension at presentation of ≥30 mm. Funding: National Cancer Institute.
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