Re: ISIS Hurls Gay Men Off Buildings
You obviously didn’t read the link…that’s why ages old argument of comparing anal cancer with cervix cancer.
Dr. Goldstone, assistant clinical professor, Mount Sinai School of Medicine, New York, and medical director of gayhealth.com, said that he sees many gay men in his general surgery practice. The appearance of anal cancer in this population is a recent but growing phenomenon, Dr. Goldstone said. He speculates that the disease is emerging now because it develops slowly and HIV-positive people are living longer as a result of new therapies.
Until recently, he saw almost no cases of anal cancer, he said. He described the disease as “extremely rare” and more likely to be found in elderly women. “From 1997 to 1999, I saw five cases. Before ’97, I saw one in my whole career,” he said.
Alarmed by the pathology reports he was seeing for gay men, he asked Joel M. Palefsky, MD, of the Department of Laboratory Medicine, University of California, San Francisco, to help design a study.
“From 1997 to 1999, I collected 200 patients who were referred to my practice for anal warts, hemorrhoids, fissures, anal itch—problems you would never associate with precancerous conditions,” Dr. Goldstone said.
The majority—157 patients (79%)—came with a referral diagnosis of condyloma. Four (2%) had anal squamous intraepithelial lesions (ASIL), and 39 (19%) presented with other benign anorectal disorders. The patients ranged from 22 to 59 years of age; 131 (66%) were HIV positive. Standard Pap methods were used to report anal cytology according to a modified Bethesda classification. Biopsy specimens were obtained for everyone in the study.
Cytology showed that 105 patients (53%) had HSIL; only 14 (7%) had benign anal cytology. The biopsy results were even more striking: 120 patients (60%) had HSIL and 5 (3%) showed invasive squamous carcinoma. Only 11 patients (6%) had benign pathology.