Today is anal cancer awareness day. I was scheduled to present my latest research about anal cancer awareness at the International Papillomavirus Conference this week. Obviously that has been postponed due to the COVID-19 pandemic. The abstract of the study is posted below. Some key points:

• Anal cancer cases increased 2.7% each year between 2001 and 2015
• Anal cancer death rates increased 3.1% each year between 2001 and 2015
• Anal cancer is caused by HPV
• Anal cancer can be prevented through HPV vaccination
• Gay, bisexual, and other men who have sex with men are much more likely to develop anal cancer than the general population

Gay and bisexual men in the U.S. lack basic information about anal cancer

INTRODUCTION

Gay and bisexual men (GBM) are disproportionally affected by high-risk anal HPV infection and the subsequent development of anal cancer. Widespread awareness and knowledge of HPV and anal cancer among GBM is important to the success of targeted HPV vaccination and anal cancer screening. The purpose of this study is to provide population-based estimates of HPV awareness and knowledge in GBM and identify differences across demographic subgroups. 

METHODS

Data were pooled from three cycles of the Health Information National Trends Survey (2017, 2018, 2019). Results are reported for the subset of adults (>18 years) who identified as GBM (N=226). Awareness was assessed as ever having heard of HPV and knowledge was assessed as knowing that HPV can cause anal cancer. Knowledge was assessed only among respondents who were previously aware of HPV. Differences in awareness and knowledge were evaluated (chi-square and multiple logistic regression) by age, race/ethnicity, education, marital status, and sexual identity.

RESULTS

Awareness of HPV and knowledge of anal cancer were stable over the survey years (75.3% and 38.8% pooled awareness and knowledge, respectively). Awareness was significantly lower among GBM with a high school education or less (44.4%), and among those who were single/never married (71.1%) or divorced/widowed (67.7%). These differences were statistically significant after adjusting for other covariates. Of the 165 GBM who had previously heard of HPV, a larger percentage of gay (44.2%) compared to bisexual (24.4%) men new HPV could cause anal cancer. This difference remained significant after adjusting for other covariates.   

CONCLUSIONS

GBM are largely unaware that HPV can cause anal cancer, despite having high awareness of HPV itself. This is concerning given that GBM have 10-50 times higher incidence of anal cancer than the general population. Our findings suggest that information diffusion about anal cancer, and relevant health information about the benefits of HPV vaccination for anal cancer prevention, are only reaching a subset of college educated GBM. Targeted anal cancer education programs are needed.