A recent JAMA Surgery study by Welton et al. evaluated the feasibility and acceptability of offering anal cancer screening at LGBTQ+ community events for men and transgender women who have sex with men (MSM/TW), a population at increased risk for anal cancer. Incidence rates are approximately 109 per 100,000 person-years in those living with HIV and 30 per 100,000 in MSM/TW without HIV. Screening remains limited, partly due to historically sparse guidelines.
The study deployed the “SAVETHEBOTTOMS!!!” screening unit at Twin Cities Pride 2024, staffed by over 30 clinicians, research personnel, and community allies. Over two days, 144 participants aged 18–76 underwent on-site anal swab screening for cytology and high-risk HPV.
Most were cisgender men (97%) and White (85%), and 69% were currently or previously taking pre-exposure prophylaxis. Eighty-two percent had never undergone anal cancer screening, 79% had never discussed it with a healthcare professional, and 61% were unaware of their elevated risk.
On-site anal cancer screening units at LGBTQ+-focused community events may provide a unique and innovative opportunity to raise awareness of and increase screening for HPV-related anal disease
Self-swabbing was highly successful, with 85% of participants performing the procedure and 85% of these samples being satisfactory for cytologic evaluation. Participants reported high acceptability: 92% indicated they would undergo screening again, and 91% would recommend it to a friend.
Overall, 27% of participants screened positive via cytology, high-risk HPV testing, or both. Among those with positive results, 64% underwent follow-up High Resolution Anoscopy (HRA), and 28% were found to have high-grade dysplasia. These outcomes compare favourably with clinic-based screening data reported in the literature.
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The authors noted that “more than 25% of this self-selected cohort with little or no prior knowledge of their risk of anal cancer screened positive. Of positive screens, two-thirds completed follow-up HRA, and more than one-fourth had high-grade dysplasia. These results compare favourably to clinic-based screening.”
The study concluded that “on-site anal cancer screening units at LGBTQ+-focused community events may provide a unique and innovative opportunity to raise awareness of and increase screening for HPV-related anal disease in this under-screened and at-risk population.”
Paper: Welton L, Kohn J, Vera K, et al. Feasibility and Acceptability of an LGBTQ+ Community Event-Based Anal Cancer Screening Unit. JAMA Surg. Published online August 13, 2025. Access online here.
