Early Oropharyngeal cancer and screening in Gay and Bisexual Men

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Abstract This application is being submitted in response to the Notice of Special Interest (NOSI) identified as “NOT-CA- 22-057”. High-risk HPV (hrHPV) is a major transmissible cause of cancers of the anus and oropharynx in sexual minority men (SMM). Prevalence of hrHPV in SMM in Tanzania, East Africa, a LMIC, is high and probably epidemic in its largest metropolitan area, Dar es Salaam. We propose to replicate our study to invite and train Tanzanian SMM to take “selfies” of the oropharynx at sufficiently high resolution to observe potential early lesions that may be malignant. These “selfies” are rated by an expert on oropharyngeal cancer for sufficient clarity to detect early lesions. A group of 100 SMM will be recruited by both Internet and RDS seeds to participate in the study, and also offered a full course of hrHPV vaccination. An initial questionnaire on knowledge, attitudes and sexual practices will be completed on Internet and participants trained at a local NGO to take oral “selfies” which are uploaded to a firewalled Internet site for an ENT specialist to assess clarity. After enrollment, two further visits will be scheduled at 2 and 6 months for vaccination shots, and to assess retention for a future cohort study. Data on knowledge, attitudes, sexual risk practices, acceptability and feasibility of screening for oropharyngeal cancer, and hrHPV vaccination, in this population and setting will be assessed.