HPV Oropharyngeal cancer and screening in Gay and Bisexual Men

摘要： 由人乳头瘤病毒感染引起的口咽癌(OPCA)在 在过去的二十年里。它主要与性危险行为有关，特别是在 MSM。与HPV相关的口腔癌，及早通过医学口腔检查发现 和牙科医生，可以成功地诊断和治疗，与显著增加 生死存亡。为了改进筛查和检测，我们提出了一个由三部分组成的研究。第一，采访 医疗和牙科团队，既有私人的，也有联邦合格的健康中心，有大量的 GBM客户群在美国两个大城市地区，了解筛选和原因 用于口咽癌筛查和所使用的指南。第二，我们将调查1500人 GBM在美国确定关于OPCA、HPV疫苗接种知识的知识和信念 和接受，与提供者和筛查的经验，以及参与筛查的意愿。 最后，考虑到OPCa肿瘤对目测的潜在可见性，我们将评估 远程患者监测基于电信的干预的可行性。我们会问 GBM用手机自拍，与标准口语相比清晰度足够高 地标，并将这些照片发送到中央站点，在那里可以由 OPCA专科临床医生。访谈和调查数据，以及可行性结果将被使用 告知增加的筛查指南和对GBM和符合以下条件的从业者的教育 对他们进行治疗，并制定方案，提高对GBM的认识和筛查。这个 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，具有必要的清晰度，构成远程医疗的基础-- 基于对OPCA高危人群的筛查活动，并进行了严格的评估。

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.