Università degli Studi di Modena e Reggio Emilia
Corso di laurea in infermieristica - Sede di Modena
| Thesis Title | Development of an early screening method for anal carcinoma in a population at risk and its subsequent impact of assistance. |
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| Name | Preti Emilio Libero |
| Supervisor(s) | Farinetti Alberto, Domenico Alessandro Leo |
| Academic Year | 2018/19 |
| Thesis type | Research thesis |
Abstract
The aim of the study is to develop an effective early screening method for anal carcinoma, due to the rising in numbers of said disease and its devastating results, such as: considerable mortality rate, psychological distress, impact on quality of life due to frequent necessary colostomies, unspecified costs. HPV is commonly and frequently associated with anal carcinoma, especially in HIV+ patients, due to immunosuppression (which leads to HPV proliferation) and a synergy at the molecular level. The proteins encoded in the HIV directly enhances the expression of HPV proteins E6 and E7, which by binding with protein 53 and retinoblastoma of human cells suppress their ability to stop cellular growth in the event of DNA damage, leading to immortalization and thus cancer. The population that is most at risk is the MSM (men who have Sex with Men) one, reason why it was taken as primary focus of the experimental study. The most influent risk factors for said population are: receptive anal intercourse, high numbers of HIV+ individuals, frequent high number of sexual partners, possible unsafe sexual practices, tobacco, alcohol, and drug abuse, general lack of knowledge and information. With a incidence of 1/100.000 in the general population and 131/100.000 in the MSM HIV+ population anal carcinomas have an incidence 131 times higher. 20% of the patients will die in the following 5 years (mainly due to late diagnosis), and another 30% of the survivors will have to undergo mandatory colostomy (due to local failures, therapy-related damages, etc.).Anal carcinoma has therefore a high incidence in the population taken in examination, is difficult to diagnose in time, needs several heavy treatments like chemo-radiotherapy, and doesn’t have an acceptable rate of non-colostomy survivors. This causes deaths, psychological and social traumas, quality of life issues, and has an economic impact (yet to be addressed) on the sanitary system.