Dr. Ross Cranston was recruited to Pittsburgh in 2007 to create an Anal Dysplasia Clinic at the Pittsburgh AIDS Center for Treatment (PACT). The focus of the clinic, which is also open to non-PACT patients, is to address the high incidence of human papillomavirus (HPV or wart virus). HPV has been associated with anal cancer in gay men – particularly those living with HIV.
“As gay men, we run the risk of serious health issues because we don’t pay enough attention to our butts.” Dr. Cranston states. “So, one of my goals is to promote an ‘anal agenda’ that increases awareness of the medical conditions gay men are more likely to experience.” Putting the issue into perspective, he adds: “Anal health has yet to emerge as an area to which it is deemed appropriate to direct our attention. As a result, gay men in particular are unaware of their increased risk of many anal diagnoses including those related to sex or sexually transmitted infections, such as the development of anal cancer.”
Patients with an abnormal anal cytology (a test of anal cells that is used to detect abnormalities) are referred to Dr. Cranston for high-resolution anoscopy (HRA). This office procedure involves examining the anal canal using magnification. If there is evidence of high-grade dysplasia – the precursor to anal cancer – a biopsy may be performed. If high-grade dysplasia is confirmed, Dr. Cranston can then remove the lesion in order to prevent its potential progression to cancer.
“We are currently diagnosing about one case of anal cancer every 2 weeks,” says Dr. Cranston, “which is why I suggest that gay men who are HIV-positive talk to their clinician about anal dysplasia screening and have an annual anal Pap smear.” Although there are no national screening guidelines, Dr. Cranston notes, it is also suggested that HIV-negative men over 40 get tested every two to three years.
Dr. Cranston is an Assistant Professor in the Division of Infectious Disease and the Medical Director of the Pitt Men’s Study. He began his studies at the University of Edinburgh before moving to London, where he completed a fellowship in HIV and Sexually Transmitted Infection. He moved to the U.S. to conduct doctoral research at the University of California—San Francisco and then spent five years working at the UCLA Center for AIDS Research and Education in Los Angeles, where he established and ran the UCLA Anal Dysplasia Clinic.
For many years, Dr. Cranston has used his knowledge of anal dysplasia, HPV, and HIV to help countless HIV-positive men. He moved to Pittsburgh in September 2007 with his partner of 11 years, Ian McGowan, who is also employed by the University as a Professor in the School of Medicine, and is Co-Principal Investigator of the Pittsburgh-based Microbicide Trials Network.
For more information about the anal dysplasia clinic, you can call 412-647-0996 .