title: A population-based study of the extent of colorectal cancer screening in men with HIV.
abstract: BACKGROUND
  Because of the increased life-expectancy of persons with HIV, the need for age-appropriate colorectal cancer screening among these patients will increase. We examined rates of colorectal cancer screening among HIV-infected men aged 50 to 65 years.
  
  
  METHODS
  We used Ontario's administrative databases to identify all men between the ages of 50 and 65 years who were alive on April 1, 2007, and identified HIV-infected men using a validated case-finding algorithm. We excluded men with a history of colorectal cancer, anal cancer, inflammatory bowel disease and any colorectal investigation in the preceding five-years, and used multivariable regression to compare rates of colorectal cancer screening between men with and without HIV during five years of follow-up.
  
  
  RESULTS
  We identified 743,801 men between the ages of 50 and 65 years, of whom 1,432 (0.19%) were HIV-infected. The proportions of men with and without HIV who underwent any screening during the 5-year follow up period were 49.1% (95% CI 46.5% to 51.7%) and 41.4% (95% CI 41.3% to 41.5%), respectively. Compared with HIV-negative men, men with HIV had lower rates of fecal occult blood testing [adjusted rate ratio (aRR) 0.74; 95% confidence interval (CI) 0.63 to 0.87] and barium-enema radiography (aRR 0.66; 95% CI 0.39 to 1.12), but higher rates of colonoscopy (aRR 1.24; 95% CI 1.13 to 1.37), flexible sigmoidoscopy (aRR 1.72; 95% CI 1.28 to 2.30) and rigid sigmoidoscopy (aRR 2.98; 95% CI 2.26 to 3.93).
  
  
  CONCLUSIONS
  As with the general population of men aged 50 to 65 years, less than half of the population of men with HIV received colorectal cancer screening. Strategies are required to improve uptake of this intervention.
authors: Department of Family and Community Medicine, St. Michael's Hospital and University of Toronto, Toronto, ON, Canada. tantoniou@smh.ca.|St. Michael's Hospital, The Li Ka Shing Knowledge Institute, Toronto, ON, Canada. tantoniou@smh.ca.|Institute for Clinical Evaluative Sciences, Toronto, ON, Canada. tantoniou@smh.ca.
authors: Tony
authors: T
authors: Antoniou
authors: Institute for Clinical Evaluative Sciences, Toronto, ON, Canada. Nathaniel.jembere@ices.on.ca.
authors: Nathaniel
authors: N
authors: Jembere
authors: Institute for Clinical Evaluative Sciences, Toronto, ON, Canada. refik.saskin@ices.on.ca.|Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada. refik.saskin@ices.on.ca.
authors: Refik
authors: R
authors: Saskin
authors: Institute for Clinical Evaluative Sciences, Toronto, ON, Canada. alexander.kopp@ices.on.ca.
authors: Alexander
authors: A
authors: Kopp
authors: Department of Family and Community Medicine, St. Michael's Hospital and University of Toronto, Toronto, ON, Canada. rick.glazier@ices.on.ca.|St. Michael's Hospital, The Li Ka Shing Knowledge Institute, Toronto, ON, Canada. rick.glazier@ices.on.ca.|Institute for Clinical Evaluative Sciences, Toronto, ON, Canada. rick.glazier@ices.on.ca.|Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada. rick.glazier@ices.on.ca.|Centre for Research on Inner City Health, St. Michael's Hospital, Toronto, ON, Canada. rick.glazier@ices.on.ca.
authors: Richard H
authors: RH
authors: Glazier
mesh_terms: D000367:Age Factors; D000368:Aged; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D009864:Ontario / Q000453:epidemiology
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