New Cancer Test Announced by UK Researchers: May Save Thousands of Gay Men

by Kilian Melloy

EDGE Staff Reporter

Wednesday November 5, 2008

A new test for anal cancer is expected to save thousands, announced Britain's Medical Research Council (MRC) and Cancer Research UK.

A Nov. 5 news release on the test said that it is thought the rate of anal cancer in gay men is about 37 out of 100,000--an incidence that the news release noted is about equal to the rate of cervical cancer among women until the introduction of the pap smear, which allows for early detection and, along with it, medical intervention.

But there is a greater rate of anal cancer among HIV positive gay men, the release said: about 75 out of 100,000.

The effectiveness of the new screening technique was demonstated though a study that appears in Cancer Epidemiology Biomarkers and Prevention, an American journal.

The study was financed by MRC and Cancer Research UK.

Said the study's lead author, Dr. Nick Coleman, "We have uncovered a more effective way to detect anal cancer in its early stages, meaning fewer people would have to undergo the rigors of radiotherapy and chemotherapy treatment."

UK GLBT equality leader Peter Tatchell had pressured the government for such a test five years ago; with the new test proving effective, Tatchell said, "This new screening test is likely to save thousands of lives by ensuring earlier diagnosis and treatment."

Continued Tatchell, "The Cambridge medical team have done magnificent, life-saving work. I offer them my congratulations and appreciation."

Tatchell went on to say, "Two decades ago, I deduced that if the Human Papilloma Virus (HPV) causes cervical cancer in women, it must also have the potential to cause anal cancer in people who have anal sex, especially gay and bisexual men.

"I lobbied the UK government for two decades to take action but was constantly rebuffed.

"The British Medical Journal and The Lancet declined to report the issue and Cancer Research UK dismissed it. Everyone said there wasn't enough credible research to justify action.

"But that was why I was urging research, in order to establish the incidence and risk, and devise screening methods and treatment protocols.

There was foot dragging from the government, Tatchell claimed. "The replies [to Tatchell's lobbying efforts] were dismissive and illogical; typically arguing that the science on this issue was 'uncertain.'"

Continued Tatchell, "This was a limp justification for doing nothing.

"If the medical knowledge was inadequate, I argued this was all the more reason to fund pilot studies."

Added Tatchell, "...I collated fragments of US research showing that pap smears could be an effective screening tool for anal cancer, and that screening is cost-effective and can save lives."

Finally, in 2003, Tatchell's arguments were heard by Dr. John Reid, the then-new Health Secretary.

Said Tatchell, "Dr Reid immediately referred my letter to the National Screening Committee (NSC).

"Within two weeks the NSC met and agreed 'the existing evidence should be reviewed and assessed', with a view to funding further research'.

The MRC news release explains that the new screening procedure looks for MCMs, or "minichromosome maintenance proteins," naturally-occurring proteins that appear in tissues where cancerous and pre-cancerous cells are present.

MCMs have been used before in early detection efforts to identify the presence of cancerous, and precancerous, cells, though until now, they had not been used in the detection of anal cancer.

Said Dr. Coleman, "This is welcome news for people who are at high risk of developing anal cancer."

Continued Dr. Coleman, "Anal cancer is a difficult disease to detect and many cases are identified after it becomes too late for people to undergo simple surgery to remove it. We wanted to create a test which was easier to perform and had a high rate of accuracy.

"This study suggests that MCM testing fits the bill very well indeed."

The new test was shown to identify the presence of diseased cells in 84 percent of subjects with anal cancer, but not to generate many false positive results.

Said Dr. Coleman, "This is a much better overall performance than existing methods of detecting anal disease, which either miss too many cases or show up as positive when no disease is actually there.

"MCM tests can also be read by a computer, which would avoid the risk of human error and be a cheaper option too."

Kilian Melloy serves as EDGE Media Network's Assistant Arts Editor. He also reviews theater for WBUR. His professional memberships include the National Lesbian & Gay Journalists Association, the Boston Online Film Critics Association, The Gay and Lesbian Entertainment Critics Association, and the Boston Theater Critics Association's Elliot Norton Awards Committee.

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