ASHM Report Back

Clinical posts from members and guests of the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) from various international medical and scientific conferences on HIV, AIDS, viral hepatitis, and sexual health.

Do you dare?

  • Font size: Larger Smaller
  • Hits: 180
  • Print

Dr Jason Ong:Monash Uni,The Alfred,MSHC

On Prevention of Anal  Cancer in Gay and Bisexual men:the current state of play and future directions

Excellent series of sessions

This session highlighted that we must reflect on some of the changing practices of rapid testing ,increase testing ,self  testing and remember the need for clinical examination also: LOOK

HPV VACCINE :THE GAME CHANGER

But a cohort has missed out

Do we adopt cervical screening protocol and do "chap smears"

Highlighted the key difference with anal Ca and cervical Ca although both SCC

Anal pap larger area,harder to identify lesioms in a collapsing environment,

Differing natural history

Differing referral rates,massive need for HRA/not feasible

No one agees best approach

Still no proof treatment assists outcome

.?trace the 30% males with HGAIN

Need better ways to treat,more RCT havent the specialists

Greater than 50% Anal Ca externally visible average lesion 2.9cm HUGE

BUTLess than 10% HIV  MSM  have annual anal exam

Need early Ca detection model:less than 2cm lesion possibly just excision with no spread or sphincter involvement,no chemo or radiation

Implement anal digital

Based on Wilson and Jungner screening critera 

;"GIVING THE FINGER TO ANAL CANCER"his PhD title

Key findings ;all specialists think it is important to screen for anal Ca but arent doing it

www.anal.org.au/clinician MSHC;:

Annual DARE study and recommendations

Acceptable,minimal s/e

99% clients willing to have annual dare

Dare is cost effective,safe,acceptable

TIME TO Do DARE translating evidence into action

Summarised;

Screen for precursor lesions

Triage

RCT FOR DARE unlikely

Jason is running an educational session at the ASHM hub Friday

DO YOU DARE?

Timely as Tasmania Sexual Health are  fortunate to have Prof Richard Turner:Colorectal surgeon Royal Hobat Hospital/UTAS

Continuing his research with monitoring HSIL anal paps :HRA ,histology ?treatment for HIV clients and Women with HSIL paps

He has spent time to demostrate DARE  to all clinicians and advises annual DARE

The final session by Brad Atkins of his horror story of his  diagnoses and treatment of anal cancer and being totally uninformed and underprepared and to be reminded of the STIGMA,embarrasment people feel

Makes it urgent to "AT LEAST LOOK AND PUT YOUR FINGER IN OR YOU WILL MISS IT"

BACK TO THE BASICS.....

  • No comments made yet. Be the first to submit a comment

Leave your comment

Guest
Guest Thursday, 23 November 2017

RT @hepqld: Curing #hepatitis C is easy, and no longer needs a specialist to prescribe treatment. Community doctors play a pivotal role in…

ASHM ASHM