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The impact of body mass index and physical disability on home-based anal self-sampling

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Abstract

Purpose

Self-sampling is increasingly being used in screening programs, yet no studies to date have examined the impact of bodily characteristics on self-sampling experiences. Our objective was to assess whether body mass index (BMI) and physical disability were associated with anal self-sampling difficulty.

Methods

We recruited sexual minority men (SMM) and trans persons in Milwaukee, Wisconsin to participate in an anal cancer screening study. Between January 2020 and August 2022, 240 participants were randomized to a home (n = 120) or clinic (n = 120) screening arm. Home participants received a mailed at-home anal self-sampling kit and were asked to attend a baseline clinic visit where biometric measurements were collected. Participants were asked to complete a survey about their experience with the kit. This research utilized data from participants who used the at-home kit and completed a baseline clinic visit and post-swab survey (n = 82). We assessed the impact of BMI and physical disability on reported body or swab positioning difficulty.

Results

Most participants reported no or little difficulty with body positioning (90.3%) or swab positioning (82.9%). Higher BMI was significantly associated with greater reported difficulty with body positioning (aOR = 1.10, 95% CI 1.003–1.20, p = 0.04) and swab positioning (aOR = 1.11, 95% CI 1.02–1.20, p = 0.01). Although not significant, participants who said body positioning was difficult had 2.79 higher odds of having a physical disability. Specimen adequacy did not differ by BMI category (p = 0.76) or physical disability (p = 0.88).

Conclusion

Anal self-sampling may be a viable option to reach obese persons who may be more likely to avoid screening due to weight-related barriers.

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Data availability

The datasets generated during the current study are not publicly available.

References

  1. American Cancer Society, Inc (2023) Key statistics for anal cancer. Retrieved from https://www.cancer.org/cancer/anal-cancer/about/what-is-key-statistics.html

  2. Clifford GM, Georges D, Shiels MS, Engels EA, Albuquerque A, Poynten IM et al (2021) A meta-analysis of anal cancer incidence by risk group: toward a unified anal cancer risk scale. Int J Cancer 148(1):38–47

    Article  PubMed  CAS  Google Scholar 

  3. United States Preventive Services Task Force (2022) Opportunity for public comment. Retrieved from https://www.uspreventiveservicestaskforce.org/uspstf/public-comments-and-nominations/opportunity-for-public-comment

  4. Heid-Picard B, Cochand-Priollet B, Rozenberg F, Giang-Phang D, Viard JP, La Torre V, Ghosn J (2021) Ambulatory anal self-sampling in MSM living with HIV, an acceptable and reliable screening method. PLoS ONE 16(2):e0246338

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  5. Tamalet C, Ravaux I, Dhiver C, Menard A, Colson P, Stein A (2016) Feasibility and acceptability of anal self-sampling for human papillomavirus screening in HIV-infected patients. Intervirology 59(2):118–122

    Article  PubMed  Google Scholar 

  6. Botes LP, Jin F, Bourne C, Pett S, Marriott D, Carr A, Hillman RJ (2011) Participants’ perspectives of self-collected anal cytological swabs. Sex Health 8(2):257–258

    Article  PubMed  Google Scholar 

  7. Centers for Disease Control and Prevention (2022) Adult obesity facts. Retrieved from https://www.cdc.gov/obesity/data/adult.html

  8. Health Policy Institute. Obesity among older Americans. Retrieved from https://hpi.georgetown.edu/obesity2/

  9. Urbute A, Kjaer SK, Kesmodel US, Frederiksen K, Thomsen LT (2022) Women with obesity participate less in cervical cancer screening and are more likely to have unsatisfactory smears: results from a nationwide Danish Cohort Study. Prev Med 159:107072

    Article  PubMed  Google Scholar 

  10. Serrano B, Ibáñez R, Robles C, Peremiquel-Trillas P, de Sanjosé S, Bruni L (2022) Worldwide use of HPV self-sampling for cervical cancer screening. Prev Med 154:106900

    Article  PubMed  CAS  Google Scholar 

  11. Nyitray AG, Schick V, Swartz MD, Giuliano AR, Fernandez ME, Deshmukh AA, Chiao EY (2021) Rationale and design of the Prevent Anal Cancer Self-Swab Study: a protocol for a randomised clinical trial of home-based self-collection of cells for anal cancer screening. BMJ Open 11(6):e051118

    Article  PubMed  PubMed Central  Google Scholar 

  12. Centers for Disease Control and Prevention (2022) About adult BMI. Retrieved from https://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/index.html#InterpretedAdults

  13. IBM Corp (2021) IBM SPSS statistics for windows, version 28.0. IBM Corp, Armonk, NY

  14. Amy NK, Aalborg A, Lyons P, Keranen L (2006) Barriers to routine gynecological cancer screening for White and African–American obese women. Int J Obes 30(1):147–155

    Article  CAS  Google Scholar 

Download references

Acknowledgments

We would like to thank the study participants, the community advisory board, and the PAC Study Team (Bridgett Brzezinski, Madison Humphry, Cameron Liebert, Esmeralda Lezama-Ruiz, Maritza Pallo, and Christopher Ajala). We also thank the Medical College of Wisconsin Tissue Bank for specimen processing and COPAN Italia S.p.A. for donating some of the swabs used in this study.

Funding

This work was supported by the National Cancer Institute of the National Institutes of Health [R01CA215403 to AGN] and Clinical and Translational Science Institute grant support [2UL1TR001436]. These funding entities had no involvement in the design, collection, analysis, or interpretation of data, writing of this report, or decision to submit this research for publication. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Author information

Authors and Affiliations

  1. Department of Psychiatry and Behavioral Medicine, Center for AIDS Intervention Research, Medical College of Wisconsin, 2071 North Summit Avenue, Milwaukee, WI, 53202, USA

    Jenna Nitkowski & Alan G. Nyitray

  2. Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA

    Maria E. Fernandez

  3. Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA

    Tim Ridolfi

  4. MD Anderson Cancer Center, The University of Texas, Houston, TX, USA

    Elizabeth Chiao

  5. Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center and Research Institute, Tampa, FL, USA

    Anna R. Giuliano

  6. Department of Management, Policy and Community Health, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA

    Vanessa Schick

  7. Department of Biostatistics and Data Science, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA

    Michael D. Swartz

  8. Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Jennifer S. Smith

  9. Cancer Center, Medical College of Wisconsin, Milwaukee, WI, USA

    Alan G. Nyitray

Authors
  1. Jenna Nitkowski
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  2. Maria E. Fernandez
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  3. Tim Ridolfi
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  4. Elizabeth Chiao
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  5. Anna R. Giuliano
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  6. Vanessa Schick
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  7. Michael D. Swartz
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  8. Jennifer S. Smith
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  9. Alan G. Nyitray
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Contributions

Jenna Nitkowski: writing—original draft, methodology, formal analysis. Maria Fernandez: methodology, writing—review and editing. Tim Ridolfi: writing—review and editing. Elizabeth Chiao: writing—review and editing. Anna Giuliano: writing—review and editing. Vanessa Schick: methodology, writing—review and editing. Michael D. Swartz: methodology, writing—review and editing. Jennifer S. Smith: methodology, writing—review and editing. Alan G. Nyitray: conceptualization, methodology, writing—review and editing, supervision, project administration, funding acquisition.

Corresponding author

Correspondence to Jenna Nitkowski.

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Conflict of interest

The authors have no relevant competing interests to disclose.

Ethics approval and informed consent

Informed consent was obtained from all study participants and study activities were approved by the institution’s human research protections committee (protocol #PRO00032999).

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Study participants provided informed consent for publication of the study findings.

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Nitkowski, J., Fernandez, M.E., Ridolfi, T. et al. The impact of body mass index and physical disability on home-based anal self-sampling. Cancer Causes Control 35, 161–166 (2024). https://doi.org/10.1007/s10552-023-01775-y

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  • DOI: https://doi.org/10.1007/s10552-023-01775-y

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