Kenneth A. Katz, MD, MSc, MSCE; Christina A. Clarke, PhD, MPH; Kyle T. Bernstein, PhD, ScM; Mitchell H. Katz, MD; Jeffrey D. Klausner, MD, MPH
Note: The cancer incidence data used in this study were supported by the California Department of Public Health as part of the statewide cancer reporting program mandated by California Health and Safety Code Section 103885; the National Cancer Institute's Surveillance, Epidemiology and End Results Program under contract N01-PC-35136 awarded to the Northern California Cancer Center, contract N01-PC-35139 awarded to the University of Southern California, and contract N01-PC-54404 awarded to the Public Health Institute; and the Centers for Disease Control and Prevention's National Program of Cancer Registries, under agreement 1U58DP00807-01 awarded to the Public Health Institute. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the State of California, the California Department of Public Health, the National Cancer Institute, and the Centers for Disease Control and Prevention or their contractors and subcontractors. Endorsement by any of those agencies is not intended nor should be inferred.
Potential Financial Conflicts of Interest: None disclosed.
Katz KA, Clarke CA, Bernstein KT, Katz MH, Klausner JD. Is There a Proven Link Between Anal Cancer Screening and Reduced Morbidity or Mortality?. Ann Intern Med. 2009;150:283-284. doi: 10.7326/0003-4819-150-4-200902170-00020
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Published: Ann Intern Med. 2009;150(4):283-284.
TO THE EDITOR:
We read with interest the study by Chin-Hong and colleagues (1) comparing techniques to detect anal intraepithelial neoplasia (AIN) among men who have sex with men. A more pressing question is whether sufficient evidence of effectiveness, in terms of reducing anal cancer morbidity or mortality, exists to support anal cancer screening. It does not.
No prospective studies, including randomized, controlled trials, have assessed the effectiveness of anal cancer screening (2). Instead, screening proponents have cited indirect evidence, including analogy to cervical cancer screening, to advocate for routine screening among certain populations, such as men who have sex with men (2, 3). As screening proponents rightly note, randomized, controlled trials of Papanicolaou smears for cervical cancer prevention were never conducted; evidence of effectiveness is based on data correlating increased screening and decreased cancer incidence (2).
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