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Am J Public Health. 2010 Jun;100(6):1123-9. doi: 10.2105/AJPH.2009.176446. Epub 2010 Apr 15.

Gay and bisexual men's willingness to receive anal Papanicolaou testing.

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  • 1Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.



We assessed the willingness of gay and bisexual men, who have high rates of anal cancer that might be prevented through regular screening, to receive anal Papanicolaou tests.


We surveyed a national sample of men aged 18 to 59 years who self-identified as gay (n = 236) or bisexual (n = 70).


Most respondents were willing to accept free screening (83%), but fewer would pay for the test (31%; McNemar's chi(2) = 158.02; P < .001). Willingness to pay for screening was higher among men who reported greater worry about getting anal cancer (OR [odds ratio] = 1.70; 95% confidence interval [CI] = 1.06, 2.72), higher perceived likelihood of anal cancer (OR = 1.88; 95% CI = 1.18, 2.99), and higher income (OR = 2.17; 95% CI = 1.18, 3.98), in adjusted analyses. Only 33% (17 of 51) of HIV-positive respondents, who have the highest risk for anal cancer, had received anal Papanicolaou tests.


Anal cancer screening was highly acceptable to gay and bisexual men, although cost was a major barrier. Efforts to reduce anal cancer disparities should target beliefs about anal cancer and barriers to anal Papanicolaou testing in this population.

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