Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
Am J Public Health. 2010 Jun;100(6):1123-9. doi: 10.2105/AJPH.2009.176446. Epub 2010 Apr 15.
We assessed the willingness of gay and bisexual men, who have high rates of anal cancer that might be prevented through regular screening, to receive anal Papanicolaou tests.
We surveyed a national sample of men aged 18 to 59 years who self-identified as gay (n = 236) or bisexual (n = 70).
Most respondents were willing to accept free screening (83%), but fewer would pay for the test (31%; McNemar's chi(2) = 158.02; P < .001). Willingness to pay for screening was higher among men who reported greater worry about getting anal cancer (OR [odds ratio] = 1.70; 95% confidence interval [CI] = 1.06, 2.72), higher perceived likelihood of anal cancer (OR = 1.88; 95% CI = 1.18, 2.99), and higher income (OR = 2.17; 95% CI = 1.18, 3.98), in adjusted analyses. Only 33% (17 of 51) of HIV-positive respondents, who have the highest risk for anal cancer, had received anal Papanicolaou tests.
Anal cancer screening was highly acceptable to gay and bisexual men, although cost was a major barrier. Efforts to reduce anal cancer disparities should target beliefs about anal cancer and barriers to anal Papanicolaou testing in this population.
我们评估了具有较高肛门癌发病率(通过定期筛查可能预防)的男同性恋和双性恋者接受肛门巴氏涂片检查的意愿。
我们调查了一个年龄在 18 至 59 岁之间、自我认同为男同性恋(n=236)或双性恋(n=70)的男性的全国性样本。
大多数受访者愿意接受免费筛查(83%),但较少愿意支付检查费用(31%;McNemar's chi(2)=158.02;P<.001)。在调整后的分析中,报告对患肛门癌的担忧程度较高(OR[比值比]=1.70;95%置信区间[CI]=1.06,2.72)、认为患肛门癌的可能性较高(OR=1.88;95%CI=1.18,2.99)和收入较高(OR=2.17;95%CI=1.18,3.98)的男性,更愿意支付筛查费用。在接受调查的 HIV 阳性者中,只有 33%(17/51)接受过肛门巴氏涂片检查,而他们是肛门癌风险最高的人群。
肛门癌筛查对男同性恋和双性恋者来说是高度可接受的,尽管费用是一个主要障碍。为减少肛门癌的差异,应针对该人群对肛门癌的认识和肛门巴氏涂片检查的障碍采取措施。