Self-reported anal cancer screening experiences in MSM: recency, follow-up, and methodological insights

Men who have sex with men (MSM) are disproportionately affected by human papillomavirus (HPV)-associated anal cancer. Prior to national anal cancer screening guidelines, literature suggested that the overall utilization of screening was low, with slightly higher uptake in MSM living with human immunodeficiency virus (HIV). The objective of this study was to report the recency of anal cancer screening by various screening methods and describe differences in self-reported screening histories by HIV status in MSM. We also aimed to comment on the use of cross-sectional methods for research on anal cancer screening utilization in MSM.

This cross-sectional survey recruited MSM in Minnesota from two online dating sites to participate in a single survey on anal cancer screening experiences. Fisher's exact tests and t-tests were used to examine differences in demographics and screening experiences by HIV status.

A total of 52 MSM participated in the survey, and 38 provided data on previous anal cancer screening experiences. Most participants were white (65.4%), gay (88.5%), and HIV-negative (69.8%). Approximately 57% of MSM living with HIV self-reported an experience with anal cancer screening in the last year compared to 37.5% of MSM living without HIV (p = 0.32). Screening was often recommended by HIV providers for MSM living with HIV (66.7%) versus primary care providers for HIV-negative MSM (47.2%, p < 0.01). MSM living with HIV more often reported a history of an abnormal result compared to HIV-negative MSM (71.4% vs. 29.2%, p = 0.018).

Our findings suggest that MSM in Minnesota are utilizing anal cancer screenings in accordance with current recommendations. MSM living with HIV were more likely to report a history of HPV-related infections and abnormal results, supporting continued prioritization of screening in this population. The differences in recommending providers by HIV status highlight the need for additional training to support equitable and consistent practices. Finally, we suggest the use of alternative methods to document future anal cancer screening utilization in MSM.