Oral/oropharyngeal "selfies" in gay and bisexual men: a pilot study exploring oropharyngeal screening for HPV-related possible malignancies.

Objectives: This study aims to determine the potential uptake and quality of oropharyngeal "selfies" taken by gay/bisexual men as a screening approach for HPV-associated oropharyngeal cancer. Methods: From 1,699 gay/bisexual men in the US, surveyed about knowledge and attitudes to HPV-associated oropharyngeal cancer, a random sample of 320 men were invited to take an oropharyngeal "selfie" by smartphone and send it to the study website: 113 (35.5%) did so. Images were rated for quality by three healthcare professional raters blinded to each other's rating, with an otolaryngologist as the gold standard. In the second wave, those whose images were rated as unacceptable were sent a short instructional video and asked to send another image. Of the 65 invited, 46 did so. An additional 15.2% sent acceptable images, and a total of 28.3% of the sample was acceptable. Results: A total of 1,121 men willing to participate in the future study who believed they could take a quality "oral selfie" were potentially eligible for this activity. A random sample of 320 participated: 153 participants started (47.8%) and 113 participants (35.3%) submitted an image. Responders were more likely to be younger, have higher knowledge scores on oropharyngeal HPV-related cancer, and have had HPV vaccination. There was high agreement between the three raters. Images of good/acceptable quality were 22.1%; oropharynx partially occluded images were 29.2%; oropharynx not visible images were 18.6%; images too dark were 21.2%; and images too small were 8.8%. From the second wave of requests with instructional videos, an additional 15.2% sent in quality images, with the remaining issues being partial occlusion of the tonsils by the tongue. Conclusion: One-third of the invited gay and bisexual men sent oropharyngeal selfie images to the study website and a total of 28.3% were of clinically acceptable quality. Following an instructional video on poorer-quality images, additional quality images were received. One barrier, i.e., partial occlusion of the oropharynx by the tongue remained. Quality oropharyngeal "selfies" are obtainable online.

Screening for HPV-Related Oropharyngeal Cancer in Gay and Bisexual Men: Acceptability and Predicting Possible Use of "Oral Selfies" by Smartphone as a Secondary Prevention Approach.

Oropharyngeal cancers (OPCa) caused by HPV have emerged as one of the leading causes of malignancies caused by HPV infection. They are also significantly more likely to occur in males and in people with a history of oral sex with multiple partners. Gay and bisexual men are disproportionately affected by HPV-positive oropharyngeal cancers. We studied 1699 gay and bisexual men on 2 major dating sites in the US to assess their knowledge about HPV-related OPCa, attitudes toward screening for it, beliefs about oropharyngeal cancer screening based on the Health Belief Model, and attitudes toward possible screening approaches for OPCa. Knowledge on a 12-item scale was low, with a median of 5 items correct: 72% knew of the benefits of HPV vaccination. Significant predictors of needing OPCa screening included perception of risk for OPCa, seeing it as severe, having lower barriers, fewer reasons to avoid screening, higher knowledge, and being HPV vaccinated were significant predictors, explaining half the total variance. Most participants would accept routine, virtual/online doctor or dental appointments, and over half would accept an in-person screening. Nearly two-thirds stated that they would accept getting checked for OPCa if they could do self-screening at home, and half were prepared to use an online screening tool or app, where they could take an "oral selfie" and send it to a healthcare provider for examination. One-third stated that they would trust the results of a home screening completed by themselves and posted to a website equally as cancer screening completed online by a healthcare provider. Data indicate that despite low OPCA knowledge levels, the risk of HPV-associated OPCa was known. Being at personal risk and having knowledge of disease severity had 70% of the sample thinking about, or preparing to get, screening. Self-screening by a smartphone "oral selfie" transmitted to a screening website was acceptable to many gay and bisexual men, and online screening by a doctor or dentist was acceptable to most. OPCa screening in this population using electronic technology, together with the increasing incidence of HPV-associated OPCa in gay and bisexual men, brings together an opportunity to detect OPCa early.

Examining the Role of HPV Communication Training in the Knowledge, Attitudes, Comfort, and Confidence of Dental Hygiene Students.

Purpose: Human papillomavirus-positive oropharyngeal cancer (HPV-OPC) is the most common HPV-associated cancer. The purpose of this study was to explore the role of a curriculum that utilized brief motivational interviewing (BMI) strategies on the knowledge, attitudes, comfort, and confidence of dental hygiene students regarding communication about HPV.Methods: Junior and senior dental hygiene (DH) and dental therapy (DT) students participated in this retrospective study. Senior students (n=26) were assigned to the control group while junior students (n=31) were assigned to the intervention group. Both groups completed an online HPV education module. The intervention group was trained in BMI techniques for communication on HPV while the control group did not receive any additional guidance. Both groups were required to have HPV discussions with two patients. Pre-test/post-test questionnaires were administered via an online software program for each patient encounter. Descriptive statistics were used to analyze the data.Results: Thirty-one intervention group and 26 control group participants completed the pre- and post-test quizzes and questionnaires. While knowledge improved for both groups from pre-test to post-test one (+5.3 % correct, p=0.001) and post-test two (+3.2, p=0.04) it was not statistically significantAttitude scores were higher in the control group at post-test one (3.25 vs 3.01, p=0.07) and post-test two (3.14 vs 2.91, p=0.05). Confidence was higher in the control group at post-test one (3.16 vs 2.82, p=0.05) and post-test two (3.21 vs 2.69, p=0.006). Comfort was higher in the control group at post-test one (3.16 vs 2.56, p=0.002) but not at post-test two (2.65 vs 2.83, p=0.45).Conclusion: Results from this study suggest that dental hygiene education programs should include didactic instruction on HPV, the use of BMI strategies, as well as multiple opportunities to practice HPV related conversations to improve student knowledge, attitudes, comfort, and confidence levels. Interactive continuing education programs with a focus on HPV and BMI techniques can also assist oral health care providers in the delivery of provider-patient communication on HPV.