You make a good point and obviously tests such as this need to show efficacy to be supported by the medical comnmunity. However cost effectiveness regarding the use of anal paps and efficacy in terms of reducing the number of invasive cancers has been done. Most of the research has been done with respect to anal paps, HRA's (high resolution anoscopy) and even the benefits of providing the Gardasil vaccine to men.
Unfortunately, the majority of these studies have not included women. They have been conducted with a patient population, usually encompassing the male homosexual and bisexual community.
It was just those studies regarding the benefits of the Gardasil vaccine which could easily be extrapolated regarding the female population and which was presented to the FDA prior to its decision to approve the use of the vaccine in boys and young men.
Those physicians focusing on infectious disease (primarily HPV) and specialize in colorectal involvement (Drs. Stephen Goldstone and Joel Palefsky for example) are dismayed with the medical professions lack of focus on this issue.
Given the fact that the majority of all anal cancers are attributed to HPV and that the perianal/anal tissue (like the oral mucosa) are relatively no different than that of the cervix this type of screening should be embraced just as the use of oral screening has now that HPV has been shown to exceed as the cause of oral cancers in non-smoking young men and exceeding the number of cases of cervical cancer, the unfortunate truth is that it has not.
Much of this still has to do with numbers, there are fewer cases of anal cancer than either cervical or oral cancers, and also that people are still uncomfortable discussing the anus. Ten years ago discussing colon cancer was not a comfortable subject matter either but time has changed that and hopefully will do the same with anal cancer in general. If you are one of those who develops anal cancer, the fact that 5,000 fewer cases are diagnosed in a year doesn't mean much. For women, it is a known fact that womn with prior cervical involvement have a significantly higher likelihood of developing anal cancer.
There already exists sufficient evidence from a medical standpoint to warrant anal pap screening. For those who are at higher risk it is especially important to have these services available and if a physician begins losing business as a result of not providing such a service I'm sure that would change very quickly. Unfortunately it should not take something like this for doctors to provide them.
The drumbeat for oral cancer screening can aleady be heard and the connection of these particular oral cancers to HPV is far more recent than that of anal cancers. Anal cancers have been on the rise for the past ten years. Women suffragettes have been around for a long time and there is power in numbers and in speaking out. Reformers in any arena recognize that things do not change over night but failing to speak up does nothing at all. Is it the sole determining factor, of course not, but no one should underestimate the power the exists in numbers when it comes to effectuating change.
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You make a good point and obviously tests such as this need to show efficacy to be supported by the medical comnmunity. However cost effectiveness regarding the use of anal paps and efficacy in terms of reducing the number of invasive cancers has been done. Most of the research has been done with respect to anal paps, HRA's (high resolution anoscopy) and even the benefits of providing the Gardasil vaccine to men.
June 17, 2011 - 8:41pmUnfortunately, the majority of these studies have not included women. They have been conducted with a patient population, usually encompassing the male homosexual and bisexual community.
It was just those studies regarding the benefits of the Gardasil vaccine which could easily be extrapolated regarding the female population and which was presented to the FDA prior to its decision to approve the use of the vaccine in boys and young men.
Those physicians focusing on infectious disease (primarily HPV) and specialize in colorectal involvement (Drs. Stephen Goldstone and Joel Palefsky for example) are dismayed with the medical professions lack of focus on this issue.
Given the fact that the majority of all anal cancers are attributed to HPV and that the perianal/anal tissue (like the oral mucosa) are relatively no different than that of the cervix this type of screening should be embraced just as the use of oral screening has now that HPV has been shown to exceed as the cause of oral cancers in non-smoking young men and exceeding the number of cases of cervical cancer, the unfortunate truth is that it has not.
Much of this still has to do with numbers, there are fewer cases of anal cancer than either cervical or oral cancers, and also that people are still uncomfortable discussing the anus. Ten years ago discussing colon cancer was not a comfortable subject matter either but time has changed that and hopefully will do the same with anal cancer in general. If you are one of those who develops anal cancer, the fact that 5,000 fewer cases are diagnosed in a year doesn't mean much. For women, it is a known fact that womn with prior cervical involvement have a significantly higher likelihood of developing anal cancer.
There already exists sufficient evidence from a medical standpoint to warrant anal pap screening. For those who are at higher risk it is especially important to have these services available and if a physician begins losing business as a result of not providing such a service I'm sure that would change very quickly. Unfortunately it should not take something like this for doctors to provide them.
The drumbeat for oral cancer screening can aleady be heard and the connection of these particular oral cancers to HPV is far more recent than that of anal cancers. Anal cancers have been on the rise for the past ten years. Women suffragettes have been around for a long time and there is power in numbers and in speaking out. Reformers in any arena recognize that things do not change over night but failing to speak up does nothing at all. Is it the sole determining factor, of course not, but no one should underestimate the power the exists in numbers when it comes to effectuating change.
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