@article{8deb8cb9eecd4a5b8471c073d6ca5563,
title = "The Utility of Digital Anal Rectal Examinations in a Public Health Screening Program for Anal Cancer",
abstract = "Objectives There are no uniform screening recommendations for anal cancer. Medical practice guidelines are now available on the use of Digital Anal Rectal Examinations (DARE) for the detection of anal cancer; however, because screening can result in more harm than benefit, our objective was to assess the evidence for use of DARE as a public health screening tool. Materials and Methods We conducted a current critical appraisal of anal cancer literature using World Health Organization criteria for assessing the potential utility of a public health screening program. Results Digital Anal Rectal Examination satisfies most, but not all, World Health Organization criteria for a public health program that seeks to detect early invasive anal cancer in populations at high risk for anal cancer, most notably HIV-positive men who have sex with men; however, DARE is not appropriate when facilities for treatment are nonexistent. In addition, there are insufficient data on DARE sensitivity and specificity. Conclusions The mildly invasive nature of DARE, limited likelihood of adverse procedure-related events, cost-effectiveness and patient acceptability, as well as wide availability of DARE support consideration of its integration into screening for populations at high risk of anal cancer, especially HIV-positive men who have sex with men.",
keywords = "DARE, Digital Anal Rectal Examination, HIV, anal cancer, anal neoplasms, mass screening, men who have sex with men",
author = "Nyitray, {Alan G.} and Gypsyamber D'Souza and Stier, {Elizabeth A.} and Gary Clifford and Chiao, {Elizabeth Y.}",
note = "Funding Information: 1Clinical Cancer Center and Center for AIDS Intervention Research, Medical College of Wisconsin, Milwaukee, WI; 2Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; 3Department of Obstetrics and Gynecology, Boston University School of Medicine, Boston, MA; 4International Agency for Research on Cancer, Lyon, France; 5Section Infectious Diseases, Department of Medicine, Baylor College of Medicine, Houston, TX; and 6Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey VA Medical Center, Houston, TX Reprint requests to: Alan G. Nyitray, PhD, Clinical Cancer Center and Center for AIDS Intervention Research, Medical College of Wisconsin, 8701 Watertown Plank Rd, Suite C5400 Milwaukee, WI 53226. E-mail: anyitray@mcw.edu The authors have declared they have no conflicts of interest. This study was supported by National Cancer Institute, National Institutes of Health (USA), 1R01CA232892 (A.G.N.); U01-HL146193 (NIH, G.D.). Publication and report contents are solely the responsibility of the authors and do not necessarily represent the official views of the NCI or of the International Agency for Research on Cancer/World Health Organization. Copyright {\textcopyright} 2020 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the ASCCP. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Deriva-tives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. DOI: 10.1097/LGT.0000000000000508 Publisher Copyright: {\textcopyright} Lippincott Williams & Wilkins.",
year = "2020",
month = apr,
day = "1",
doi = "10.1097/LGT.0000000000000508",
language = "English (US)",
volume = "24",
pages = "192--196",
journal = "Journal of lower genital tract disease",
issn = "1089-2591",
publisher = "Lippincott Williams and Wilkins",
number = "2",
}