{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T21:30:27Z","timestamp":1761514227707,"version":"3.37.3"},"reference-count":23,"publisher":"BMJ","issue":"2","funder":[{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Trefler Practitioner Program for Cancer Equity at the Kraft Center for Community Health Leadership"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2018,6,6]]},"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>High-resolution anoscopy (HRA) is a potential screening method for detection of anal cancer precursors. We evaluated factors associated with adherence to recommended HRA follow-up time intervals among men who have sex with men (MSM).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We employed a retrospective, observational cohort study with 155 MSM screened by HRA between 1 April 2011 and 31 March 2016 at a Federally Qualified Health Centre in Boston, Massachusetts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The sample was 80% white, with a median age of 48 (non-normal distribution, IQR 15). All patients were assigned male sex at birth and none identified as transgender. Fifty patients (32%) followed up with a HRA appointment within 6\u2009months of previous HRA detection of anal high-grade squamous intraepithelial lesion (HSIL). Among patients, 112 (72%) were HIV infected, 56 (36%) had a syphilis diagnosis during the study period, 89 (57.4%) had initiated Hepatitis A or B vaccination series, 70 (45.2%) accessed case management services and 19 (12.3%) utilised pre-exposure prophylaxis (PrEP). In bivariate analysis, patients who underwent recommended follow-up HRA within 6 months of HSIL diagnosis were less likely to report: case management utilisation (p=0.023), initiation of Hepatitis A or B vaccination (p=0.047), HIV diagnosis (p&lt;0.001) and syphilis diagnosis (p=0.001), but were more likely to use HIV PrEP (p&lt;0.001). In binomial logistic regression modelling after adjusting for age and race\/ethnicity, patients who had follow-up with HRA within a recommended period of 6 months after HSIL diagnosis were less likely to have initiated Hepatitis A or B vaccination (adjusted OR 0.43, 95%\u2009CI 0.20 to 0.94), more likely to use PrEP (adjusted OR 4.47, 95%\u2009CI 1.30 to 15.49) and less likely to have a syphilis diagnosis (adjusted OR 0.34, 95%\u2009CI 0.14 to 0.86).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Three-quarters of patients with HSIL did not have follow-up HRA within the clinic\u2019s recommended follow-up period of 6 months following HSIL diagnosis by HRA. Future studies ought to explore whether addressing anal health during other STI-related care helps improve adherence to recommended time intervals for follow-up HRA. Given the high prevalence of STI and PrEP use, studies might also evaluate whether integrating HRA follow-up with other sexual health screenings helps improve adherence to recommended HRA follow-up.<\/jats:p><\/jats:sec>","DOI":"10.1136\/sextrans-2017-053515","type":"journal-article","created":{"date-parts":[[2018,6,22]],"date-time":"2018-06-22T16:20:16Z","timestamp":1529684416000},"page":"83-86","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":15,"title":["Factors associated with anal cancer screening follow-up by high-resolution anoscopy"],"prefix":"10.1136","volume":"95","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6624-8354","authenticated-orcid":false,"given":"Kaan Z","family":"Apaydin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andy","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina P C","family":"Borba","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Derri L","family":"Shtasel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharon","family":"Ulery","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth H","family":"Mayer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex S","family":"Keuroghlian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,6,22]]},"reference":[{"key":"2024092304402079000_95.2.83.1","unstructured":"Howlader N , Noone AM , Krapcho M , et al . 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