HPV Oropharyngeal cancer and screening in Gay and Bisexual Men

摘要： 由人类乳头瘤病毒感染引起的口咽癌（OPCa）在 过去的二十年它主要与性风险行为有关，特别是在 男男性接触者与HPV相关的口腔癌，当通过医学检查早期发现时， 和牙科医生，可以成功地诊断和治疗，与显着增加 生存为了提高筛查和检测，我们提出了一个3部分的研究。第一，面试 医疗和牙科团队，包括私人和联邦合格的健康中心， GBM的客户群分布在美国两个大都市区，了解筛选和原因 用于口咽癌筛查和使用的指南。第二，我们将调查1500名 在美国的GBM，以确定有关OPCa，HPV疫苗接种知识的知识和信念 和吸收，与提供者和筛查的经验，以及参与筛查的意愿。 最后，鉴于OPCa肿瘤对口腔视力检查的潜在可见性，我们将评估 远程患者监测的可行性，基于预防的干预。我们会要求 GBM采取口头“自拍”与手机，足够清晰的关于标准的口头 地标，并将这些照片发送到一个中心网站，在那里可以进行评估， OPCa专科临床医生。访谈和调查数据以及可行性研究结果将被使用 为GBM和从业者提供更多的筛查指南和教育， 治疗他们，并制定计划，提高认识和筛查GBM。的 可接受性、可行性和初步疗效数据将评估自我检查和 口头“自拍”是现实的，并具有必要的清晰度，以形成远程医疗的基础- 为那些有发展OPCa风险的人开展基于筛查的运动，并对其进行严格的评估。

Abstract: Oropharyngeal cancer (OPCa) caused by Human Papilloma Virus infection has risen steadily in the past two decades. It is primarily associated with sexual risk behavior, specifically oral sex in MSM. Oral cancers associated with HPV, when detected early by oral examination by medical and dental practitioners, can be successfully diagnosed and treated, with significantly increased survival. To improve screening and detection, we propose a 3-part study. First, to interview medical and dental teams, both private and in a Federally Qualified Health Center, with large GBM client bases in two large US metropolitan areas, to understand the screening and reasons for screening for oropharyngeal cancers and guidelines used. Second, we will survey 1500 GBM in the US to determine knowledge and beliefs about OPCa, HPV vaccination knowledge and uptake, experiences with providers and screening, and willingness to engage in screening. Finally, given the potential visibility of OPCa tumors to oral visual examination, we will assess the feasibility of a remote patient monitoring telecommunications-based intervention. We will ask GBM to take oral “selfies” with a cell phone, of sufficient clarity in regard to standard oral landmarks, and to send these photos to a central site where assessment can be made by an OPCa specialist clinician. The interview and survey data, and the feasibility results will be used to inform increased screening guidelines and education for both GBM and the practitioners who treat them, and to develop programs for increased awareness and screening in GBM. The acceptability, feasibility and preliminary efficacy data will assess whether self-examination and oral “selfies” are realistic and have the necessary clarity to form the basis of a telemedicine- based screening campaign for those at risk of developing OPCa, and its rigorous evaluation.