Anal Cancer Screening

They simply are not effective in reducing death from anal cancer in the general population and could lead to unnecessary emotional distress and cost. However, anal cancer screening with regular anal cytology, or anal Pap testing, is encouraged in patients at high risk for the disease.

People at high risk of developing anal cancer should talk to their gastroenterologist about the benefits and risks of being screened with regular anal Pap testing to check for signs of cancer. Those at high risk include:

• Men who have sex with men
• Women who have had cervical, vaginal or vulvar cancer
• Anyone living with human immunodeficiency virus (HIV)
• Anyone who is immunocompromised, such as organ transplant recipients
• Anyone with a history of anal warts
• Women older than 45 who have tested positive for human papillomavirus (HPV) 16

There are no specified anal cancer screening guidelines for people at high risk for the disease. Some providers recommend annual screening, particularly for patients with HIV. Screening every two to three years may be appropriate for others. Individuals at high risk should work with their gastroenterologist to determine how often they should have anal Pap tests to check for cancer.

Given the location of the anus in the body and its narrow structure, symptoms tend to be recognizable sooner as compared with cancers of the colon and rectum. The most common symptom of anal cancer is bleeding from the anus either unprovoked or with a bowel movement. Often, people assume anal bleeding is due to hemorrhoids, which can delay treatment if they put off getting a proper diagnosis.

• Anyone experiencing anal bleeding or the following signs and symptoms of anal cancer should talk to their doctor right away.
• Itching at the anus
• A lump or pain near the anus
• A sense of fullness or a need for a bowel movement that doesn’t resolve with defecation
• Narrow stool
• Abnormal discharge from the anus
• Loss of bowel control
• Swollen lymph nodes near the anus or in the groin

These symptoms can be caused by a variety of gastrointestinal conditions, including hemorrhoids and anal warts and fissures. The vast majority of people who experience these symptoms do not have anal cancer. Still, it’s important to seek a diagnosis right away. The sooner anal cancer is diagnosed, the better your prognosis will be.

Researchers at Winship are currently studying the potential of blood-based tests to screen for anal and other cancers. Once developed, a blood test could be used to detect anal cancer in high-risk individuals at earlier stages.