Oropharyngeal cancer (OPCa) caused by Human Papilloma Virus infection has risen steadily in
the past two decades. It is primarily associated with sexual risk behavior, specifically oral sex in
MSM. Oral cancers associated with HPV, when detected early by oral examination by medical
and dental practitioners, can be successfully diagnosed and treated, with significantly increased
survival. To improve screening and detection, we propose a 3-part study. First, to interview
medical and dental teams, both private and in a Federally Qualified Health Center, with large
GBM client bases in two large US metropolitan areas, to understand the screening and reasons
for screening for oropharyngeal cancers and guidelines used. Second, we will survey 1500
GBM in the US to determine knowledge and beliefs about OPCa, HPV vaccination knowledge
and uptake, experiences with providers and screening, and willingness to engage in screening.
Finally, given the potential visibility of OPCa tumors to oral visual examination, we will assess
the feasibility of a remote patient monitoring telecommunications-based intervention. We will ask
GBM to take oral “selfies” with a cell phone, of sufficient clarity in regard to standard oral
landmarks, and to send these photos to a central site where assessment can be made by an
OPCa specialist clinician. The interview and survey data, and the feasibility results will be used
to inform increased screening guidelines and education for both GBM and the practitioners who
treat them, and to develop programs for increased awareness and screening in GBM. The
acceptability, feasibility and preliminary efficacy data will assess whether self-examination and
oral “selfies” are realistic and have the necessary clarity to form the basis of a telemedicine-
based screening campaign for those at risk of developing OPCa, and its rigorous evaluation.
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