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Session: ePoster: Other Neoplasia and Endoscopy 6 (Mon115)

EP804 - SAVETHEBOTTOMS!!! A Two-Year Experience Performing Onsite Anal Cancer Screening at an LGBTQ Community Event

Monday, May 12, 2025
1:47 PM – 1:52 PM PT

    ePoster Presenter(s)

  • Lindsay Welton, MD (she/her/hers)

    General Surgery Resident
    University of Minnesota
    University of Minnesota
    Minneapolis, Minnesota, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • JK

    Julia Kohn, MD (she/her/hers)

    Surgery resident
    University of Minnesota Twin Cities
    University of Minnesota
    Minneapolis, Minnesota, United States

    Disclosure information not submitted.

  • Shelbi Olson, MD (she/her/hers)

    General Surgery Resident
    University of Minnesota
    University of Minnesota
    Minneapolis, MN, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

  • DT

    Deanna Teoh, MD, MS

    Associate Professor
    University of Minnesota
    Minneapolis, Minnesota, United States

    Disclosure information not submitted.

  • KV

    Kathryn Vera, Ph.D.

    Clinical Research Program Manager
    University of Minnesota
    Hudson, Wisconsin, United States

    Disclosure information not submitted.

  • QW

    Qi Wang, MS

    Senior Biostatistician
    University of Minnesota
    Minneapolis, Minnesota, United States

    Disclosure information not submitted.

  • MW

    Mark L. Welton, MD, MHCM

    Professor of Surgery
    Univeristy of Minnesota
    Minneapolis, Minnesota, United States

    Disclosure information not submitted.

    • Senior Author(s)

  • EA

    Elliot G. Arsoniadis, MD, PhD

    Assistant Professor of Surgery
    University of Minnesota
    Minneapolis, Minnesota, United States

    Disclosure information not submitted.

    • Author(s)

  • GM

    Genevieve B. Melton, MD, PhD

    Professor of Surgery
    Univeristy of Minnesota
    Minneapolis, Minnesota, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

All of the relevant financial relationships listed below have been mitigated.
Lindsay Welton, MD: This individual has no financial relationships with ineligible companies.
Shelbi Olson, MD: This individual has no financial relationships with ineligible companies.
Genevieve B. Melton, MD, PhD: This individual has no financial relationships with ineligible companies.
Image or Table (Do Not add text here):

Purpose/Background: Anal cancer is increasing in incidence and disproportionately affects high-risk groups such as men (and transgender women) who have sex with men, yet screening rates remain low. In 2023, we piloted “SAVETHEBOTTOMS!!!”, an anal cancer screening unit at an LGBTQ community event and demonstrated that onsite screening (self or clinician collected) was both feasible and acceptable. In our second year (2024), we aimed to increase overall enrollment and participant diversity (age, race, HIV status) through improvements in the onsite unit (more space and study/recruitment staff; refined aesthetics/branding), offering free HPV vaccination, and outreach to community partners for pre-event advertising. We added high-risk HPV (hrHPV) testing in addition to cytology to better identify those most in need of follow-up High Resolution Anoscopy (HRA) and increase the likelihood of obtaining usable samples.

Methods/Interventions: The onsite screening event took place at a city Pride festival in June 2023 and 2024. Participants were ≥18, male sex at birth, and had no history of anal dysplasia. Both events included a tent for recruitment/consent and a tent for swabbing (choice of self or clinician collected). Participants completed pre/post-swab surveys. Samples were evaluated by pathologists with expertise in anal dysplasia. In 2023, participants with any abnormal cytology were invited for HRA. In 2024, participants with low-grade (LSIL) or high-grade (HSIL/ASC-H) cytology and/or hrHPV+ were invited for HRA; atypical squamous cells of undetermined significance (ASCUS) without hrHPV was considered a negative screen. In 2024, we also utilized community partner organizations to advertise the event on websites and social media.

Results/Outcomes: Enrollment increased by 43% from 2023 to 2024 (101 to 144 participants). There was a modest (5.2%) increase in non-white race and mean age (38 [18-75] to 40 [18-76]), but a decrease in persons living with HIV (-2.6%). In 2023, 96% chose to self-swab, vs. 85% in 2024. Positive screens increased from 13% (2023) to 27% (2024). Samples unsatisfactory for cytology decreased from 23% to 16.7%; only 8% were unsatisfactory for both cytology and HPV testing. In 2024, 44 chose to undergo onsite HPV vaccination. Of these, only 20 also did onsite screening. In both years, the majority of participants (74%) learned about SAVETHEBOTTOMS!!! from “passing by the booth” and >90% agreed they would undergo screening again.

Conclusion/Discussion: We describe the second iteration of our novel onsite anal cancer screening unit at an LGBTQ community event. In 2024 we increased the overall number undergoing onsite screening, with a decrease in unsatisfactory samples. HPV testing changed follow up recommendations for 33 participants, sparing 21 participants from HRA, while identifying 12 additional participants at risk. There were small increases in age and non-white race, but a decrease in HIV+. The contribution of free HPV vaccination and online posts by community partners was modest. The vast majority found out about our unit from “just passing by”, underscoring the importance of the onsite unit's visibility and appeal, as well as the recruitment staff’s ability to deliver an accurate and convincing message for anal cancer screening to members of this community who may be unaware of their risk. Future iterations will focus on building a more diverse and well-trained recruitment staff of LGBT community members and allies to better promote onsite anal cancer screening among this at-risk population.