Could Anal Pap Smears Help Early Detection Of Anal Cancer?

Hey there Guys,

Today I wanted to share a bit of new research that is happening to help reduce the rates of anal cancers in men.

Thankfully anal cancer is fairly rare however it’s important for gay men to be aware about it, as the risk is nearly 35 times higher if you have had receptive anal sex and 70 times higher if you are HIV positive.

The reason that gay men appear to be at higher risk is an increased exposure to the HPV, or Human Papilloma Virus. HPV virus is associated with genital warts including those found in the anus.

If you are HIV positive or have ever had anal warts it is highly suggested that you get yearly screening for anal cancers. Other factors that increase the risk of anal cancer in men include smoking cigarettes, and increasing age. Unless HIV positive, it is very rare to get anal cancer under the age of 40 with the average age of detection being around 65.

What are the symptoms of anal cancer?

By far the most common symptom in early anal cancer is no symptoms. About half of people with anal cancers experience bleeding from the anus while one third may have pain or a sensation of something in the anus. Other symptoms include itch, the presence of warts, discharge, or dysfunction of the anal muscles leading to potential anal leakage.

How do you get checked for anal cancer?

Majority of anal cancers are within 5 cm of the opening of the anus. This means in majority of times inserting a finger into the ass and doing a full circle sweeping motion is able to feel any changes in the lining of the anus. An interesting new test to potentially detect early anal cancers is the anal pap test.

The anal pap test is a variation on the pap smear used to diagnose cervical cancer in women. As part of testing a Dacron swab in inserted approximately 5 cm into the anus and moved in, out and around to capture cells from the anal lining to test for the HVP virus. The swab is placed into a special solution and sent to a lab where cells are stained and reviewed under a microscope. Because of the possibility of losing the cells being tested for, it’s important to not douche or have receptive anal sex at least 24 hours before the test.

Currently in Australia this test is not covered by Medicare so there would be an out of pocket cost.

It is important to note that at the moment anal pap smears are only about 60% sensitive at picking up HPV related changed in the anus which is why it’s important the test be combined with examination with a finger and using a special camera to directly look at the lining if needed. These tests are complex and currently best done by specialist centres as we learn more about their use. This said they are very promising and I hope that with time they will become more common place.

If there are any lumps noted or the smear comes back positive for HPV changes in the lining of the anus, review with a specialist is important to organise formal diagnosis and treatment.

The good news is there is effective treatments available and early detection can mean much simpler treatment regimes.

For a great summary of anal cancer be sure to check out Oncolink at the University Of Pennsylvania.

You can click here to read a personal story of one Australian man’s experience with anal cancer.

To summarise:

  • Gay men and people living with HIV are at a higher risk of developing anal cancers.
  • If you have ever had anal warts, are HIV positive or have symptoms like anal bleeding, itch, discharge, pain or leakage it’s important to be checked by your doctor.
  • Anal “Pap” smears are a new application of an older technology and is promising in the early detection of anal cancers.
  • Good news is that there are good treatments available for anal cancer and the earlier detected the better.

Guys, I hope you have found this article useful. Please feel free to leave your comments below and of course feel free to share with your friends.

Yours in good health.

Dr George

PS: Anal cancer secondary to HPV infection does not have to be inevitable. Data is emerging that shows that the HPV vaccine can reduce the chance of not just anal cancer but head, neck and throat cancer as well. Be sure to check out my post: Should You Consider The HPV Vaccine?


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