Abstract 2435: Knowledge and attitudes towards anal cancer and anal cancer screening among hispanic women at increased risk of anal cancer
Authors: Ortiz-Martinez Ana P. , Camacho Sandra García , Cartagena Jeslie M. Ramos , Ardilla Claudia Amaya , López Vivian Colón , Romaguera Josefina 
Published: August 2019

Abstract
Objective: Research shows that women with HIV infection, lower genital tract neoplasia (LGTN), organ transplants, Chron’s disease and lupus have an increased risk of anal cancers and its precursor lesion, anal intraepithelial neoplasia (AIN). Thus, an expert review, including the American Society for Colposcopy and Cervical Pathology and the International Anal Neoplasia Society, recommends anal cytology screening for these women when referral to high-resolution anoscopy (HRA) and treatment is available. Although Puerto Rico has a specialized anal neoplasia clinic since 2014, little is known about anal cancer knowledge and attitudes in women at risk for this malignancy in this population. Thus, this study aims to describe knowledge and attitudes towards anal cancer and anal cancer screening among Hispanic women at increased risk of anal cancer and AIN in Puerto Rico.
Methods: Ongoing clinic-based cross-sectional study (May-November 2018) among women receiving services at the colposcopy, gynecology oncology and lower genital tract clinics of the University of Puerto Rico. All women with gynecological neoplasia within the clinic complete an interviewer administered questionnaire and the medical record is reviewed for LGTN diagnosis. From 235 study participants (response rate=67.5%), 83 (35.3%) had a diagnosis of LGTN, HIV, lupus, Chron’s disease, or were transplant patients, and thus were considered at increased risk for anal cancer and AIN, and included in this analysis.
Results: 71.8% of women have cervical, 8.4% vulvar, and 9.6% vaginal LGTN. Meanwhile, 10.1% have HIV, 3.6%, are transplant patients, 8.4% have lupus and 2.8% Crohn’s disease. Mean age is 54.9 years (SD=1.73) and 57.8% have an annual income &lt;$15,000. Only 12.0% of study participants had ever had an anal pap, despite their increased risk. The most common reason reported for not having had an anal pap was being unaware that a test was available (56.6%). In terms of perceived risk, only 31.7% of women agree/strongly agree that they are at greater risk of anal cancer as compared to other persons of their age, although 74.7% agree/strongly agree that it concerns them a lot to develop anal cancer. Although 87.8% of women say to know nothing/little about anal cancer, 92.7% are interested in learning about this malignancy and 97.5% are willingly to undergo anal cytology if a doctor recommend it. Regarding risk factors, a moderate proportion of women knew than HIV infection (50.6%), tobacco consumption (45.1%), and anal sex (71.1%) are risk factors for anal cancer.
Conclusion: Despite low perceived risk and limited knowledge of anal cancer, there is high interest among this high-risk population to learn more about anal cancer and screening procedures. Results show the importance and the need for education in this topic for patients and physicians, to have an impact on anal cancer prevention.
Citation Format: Ana P. Ortiz-Martinez, Sandra García Camacho, Jeslie M. Ramos Cartagena, Claudia Amaya Ardilla, Vivian Colón López, Josefina Romaguera. Knowledge and attitudes towards anal cancer and anal cancer screening among hispanic women at increased risk of anal cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 2435.