Digital Anal Rectal Examination Usage Among Individuals at Increased Risk for Anal Cancer.
Digital Anal Rectal Examination Usage Among Individuals at Increased Risk for Anal Cancer.
复制标题
肛门直肠指检在肛门癌风险增加的个体中的使用。
DOI：
10.1097/lgt.0000000000000734
复制
发表时间：
2023
影响因子：
3.7
通讯作者：
PreventAnalCancerSelf-SwabStudyTeam
中科院分区：
文献类型：
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作者：
Nyitray,AlanG;Ridolfi,TimothyJ;Nitkowski,Jenna;McAuliffe,TimothyL;Deshmukh,AshishA;Giuliano,AnnaR;Chiao,ElizabethY;PreventAnalCancerSelf-SwabStudyTeam
目的多个组织建议肛门癌高危人群每年进行肛门直肠指检（DARE）。作者评估了性少数男性和变性女性的DARE使用情况。方法从美国一个中型城市招募社区和无症状个体，加入预防肛门癌自我拭子研究，这是一项肛门癌筛查的纵向临床试验。基线调查的自我报告数据用于评估过去一年和一生中DARE的使用情况。使用多变量逻辑回归确定与每个结果相关的因素的调整优势比（aORs）和CIs。结果在241名参与者中，年龄中位数为46岁（四分位数范围为33-57岁），27.0%感染艾滋病毒，24.5%报告先前诊断为肛门疣。总共有13.7%（95% CI= 9.4%-18.0%）的个体在前一年报告了DARE，而53.9%（95% CI= 47.7%-60.2%）的个体在一生中报告了DARE。以下与前一年的DARE相关：年龄增加（aOR= 1.04；每增加一年95% CI= 1.01-1.08），任何以前的肛门细胞学检查（aOR= 2.62; 95% CI= 1.19-5.80，与以前没有检查或不知道检查相比），以及肛交时偏好的接受体位（aOR= 4.93; 95% CI= 1.17-20.86，与插入相比）结论尽管指南建议每年进行一次DARE，但很少有报道。迫切需要了解在最易患肛门癌的个体及其卫生保健提供者中进行DARE的障碍。
ObjectiveMultiple organizations recommend an annual digital anal rectal examination (DARE) for people at highest risk for anal cancer. The authors assessed DARE usage among sexual minority men and transgender women.MethodsCommunity-recruited and asymptomatic individuals from a mid-sized US city were enrolled into the Prevent Anal Cancer Self-Swab Study, a longitudinal clinical trial of anal cancer screening. Self-reported data from the baseline survey were used to assess usage of DARE in the last year and during the lifetime. Adjusted odds ratios (aORs) and CIs for factors associated with each outcome were determined using multivariable logistic regression.ResultsAmong 241 participants, median age was 46 years (interquartile range, 33–57 years), 27.0% were living with HIV, and 24.5% reported a previous diagnosis of anal warts. A total of 13.7%(95% CI= 9.4%–18.0%) of individuals reported a DARE in the previous year, whereas 53.9%(95% CI= 47.7%–60.2%) reported a DARE during the lifetime. The following were associated with a DARE in the previous year: increasing age (aOR= 1.04; 95% CI= 1.01–1.08 for each additional year), any previous anal cytology (aOR= 2.62; 95% CI= 1.19–5.80, compared with no previous test or no knowledge of a test), and preferred receptive position during anal sex (aOR= 4.93; 95% CI= 1.17–20.86 compared with insertive)ConclusionsDespite guidelines recommending an annual DARE, it was uncommonly reported. There is an urgent need to understand barriers to conducting DARE among individuals most vulnerable to anal cancer and their health care providers.