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Session:: ePosters of Distinction: Potpourri

EPD507 - Demographic and Clinical Predictors of Follow-Up Adherence in High Resolution Anoscopy

Monday, May 11, 2026
4:13 PM - 4:18 PM ET

    ePoster of Distinction Presenter(s)

  • SB

    Sydney C. Beache, MD, MPHS (she/her/hers)

    Fellow
    The Ohio State University
    The Ohio State University
    Columbus, OH, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • JC Chen, MD MPH (they/them/theirs)

    Resident
    Ohio State University
    Ohio State University
    Columbus, OH, United States

    Disclosure information not submitted.

  • Nikita Wadhwani, MD (she/her/hers)

    Colon and rectal surgery fellow
    The Ohio State University
    University of Alabama at Birmingham
    Columbus, OH, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

  • Lisa A. Cunningham, MD

    Assistant Professor
    The Ohio State University
    Columbus, Ohio, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

  • AG

    Alessandra Gasior, DO

    Associate Professor
    The Ohio State University
    Columbus, Ohio, United States

    Disclosure information not submitted.

  • AH

    Alan E. Harzman, MD

    Professor
    The Ohio State University
    Columbus, Ohio, United States

    Disclosure information not submitted.

  • Emily Huang, MD, MEd

    Associate Professor
    The Ohio State University
    Ohio State University
    Columbus, OH, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

  • Amber L. Traugott, MD (she/her/hers)

    Associate Professor
    The Ohio State University
    The Ohio State University Wexner Medical Center
    Columbus, Ohio, United States

    Disclosure information not submitted.

  • Melik Kagan Aktas, MD (he/him/his)

    Postdoctoral Clinical Research Fellow
    The Ohio State University Department of Surgery
    The Ohio State University
    Columbus, OH, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

  • Michelle Chan, MD (she/her/hers)

    General surgery resident
    The Ohio State University
    The Ohio State University
    Columbus, OH, United States

    Disclosure information not submitted.

  • JZ

    Joy Zhang, MD

    General Surgery Resident
    The Ohio State University Wexner Medical Center - Columbus, OH
    Columbus, Ohio, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

  • Stephanie A. Mitchem, MS, APRN-CNP

    Certified Nurse Practitioner, Department of Surgery, Division of Colorectal Surgery
    The Ohio State University Wexner Medical Center
    The Ohio State University Wexner Medical Center, Columbus, OH
    Hebron, OH, United States

    Disclosure information not submitted.

  • Matthew F. Kalady, MD

    Professor, Division Director,
    The Ohio State University Wexner Medical Center and James Cancer Center
    Ohio State University
    Columbus, Ohio, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no relevant relationships with ineligible companies.

  • Syed Husain, MB.,BS.

    Professor of Surgery-Clinical
    The Ohio State University
    Ohio State University
    Columbus, Ohio, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

All of the relevant financial relationships listed below have been mitigated.
Sydney C. Beache, MD, MPHS: This individual has no financial relationships with ineligible companies.
Nikita Wadhwani, MD: This individual has no financial relationships with ineligible companies.
Lisa A. Cunningham, MD: This individual has no financial relationships with ineligible companies.
Emily Huang, MD, MEd: This individual has no financial relationships with ineligible companies.
Melik Kagan Aktas, MD: This individual has no financial relationships with ineligible companies.
Joy Zhang, MD: This individual has no financial relationships with ineligible companies.
Matthew F. Kalady, MD: This individual has no relevant relationships with ineligible companies.
Syed Husain, MB.,BS.: This individual has no financial relationships with ineligible companies.
Purpose/Background: High resolution anoscopy (HRA) facilitates both diagnosis and treatment of Anal Intraepithelial Neoplasia (AIN) and has been shown to significantly reduce the risk of malignant progression. However, given the recurrent nature of anal dysplasia, close HRA surveillance is required for effective cancer prevention. Adherence to a surveillance protocol can be challenging as many patients affected by anal dysplasia belong to at-risk populations facing socioeconomic and cultural barriers. Lack of consistent follow-up can potentially compromise long-term outcomes for these high-risk populations. We aim to evaluate demographic factors associated with consistent follow-up (>=2 exams) among patients who have undergone HRA and to quantify disparities in follow-up.

Methods/Interventions: Adults (>=18 years) who presented for HRA between 2014-2024 at a single academic medical center were retrospectively reviewed. Sociodemographic variables included gender, race, sexual orientation (straight, bisexual, men who have sex with men (MSM), women who have sex with women (WSW)), presence of high-risk comorbidities (including HIV, presence of immunosuppression for autoimmune disease, cancer, or transplant, and history of gynecologic dysplasia/cancer), and area deprivation index (ADI). Relationships between follow-up amongst these sociodemographic factors were evaluated using Chi-squared or Fisher's Exact test as appropriate, logistic and Poisson regression analyses.

Results/Outcomes: A total of 723 people underwent HRA. Individuals who identified as MSM had a greater proportion of consistent follow-up (68.1% vs. 31.9%, p=0.02) compared to those of other sexual orientations. Women were 42.4% less likely to have consistent follow-up (OR 0.58, 95% CI [0.35-0.91]), which remained significant when controlling for insurance type and sexual orientation. Multivariate analysis revealed that women had 11% fewer follow-up exams than men (RR 0.89, 95% CI [0.79-1.00], p=0.003), which remained significant when controlling for sexual orientation, presence of high-risk comorbidities, and ADI.

Conclusion/Discussion: While correcting for multiple socioeconomic factors, women are less likely to adhere to appropriate follow-up recommendations for HRA. Targeted patient education, standardized follow-up protocols, and broader provider education could help improve adherence to surveillance across this population.