What part of the body are we talking about?
- The anus is the body’s opening at the lower end of the intestines and is about an inch and one-half long. It opens during a bowel movement.
- The anus is lined with cells known as squamous cells.
- Squamous cell carcinomas are the most common type of anal cancer.
How common is anal cancer?
- Not so common; in 2014 there were about 7,210 new cases and about 950 deaths from anal cancer (American Cancer Society, 2014).
- Anal cancer occurs mainly in adults and is associated with age; risk increases at age 50+ years.
- Most squamous cell anal cancers are linked to the Human Papilloma Virus (HPV). This is the same virus that causes cervical cancer and women with cervical cancer are at increased risk for anal cancer.
- Persons with the Human Immunodeficiency Virus (HIV) are much more likely to get anal cancer than those who are HIV-negative.
What are risk factors for anal cancer?
- HPV
- HIV
- Persons, regardless of gender who participate in anal sex are at increased risk.
- Multiple sexual partners increase risk of HIV and HPV. Having anal sex is a risk factor for men, women, and transgender persons.
- Smoking cigarettes; quitting reduces risk.
- Immune systems weakened by HIV, organ transplants, or drugs causing suppression of immune system.
Can anal cancer be prevented?
- To protect against sexually transmitted diseases passed through anal intercourse, use a condom and water-based lubricant.
- A vaccine is available to protect infection with certain HPV subtypes (6, 11, 16, 18) and is approved to prevent anal cancers and pre-cancers. To be effective, vaccines optimally, should be taken before a person becomes sexually active.
What are common symptoms?
- Bleeding or itching around the anus.
- Pain in the anal area.
- Change in width of stool.
- Swollen lymph nodes in the anal or groin area.
- Abnormal discharge from the anus.
What are guidelines for anal pre-cancer/cancer screening?
- At present, there are no national guidelines for anal cancer screening.
- For Persons Living with HIV, some experts recommend that an anal Pap test (similar to cervical Pap) and digital rectal examination (DRE) be part of initial and routine health evaluations.
- If the first test result is normal, the anal Pap usually is repeated in about 6 months. If both results are normal, then anal Pap tests may be performed yearly.
- For those with certain HPV strains and/or who have receptive anal intercourse, screening provides an opportunity to stay healthy through timely follow-up on screening results that seem out of the ordinary. Follow-up involves anoscopy, a more sensitive procedure for examining the anus and lower rectum (American Cancer Society, 2009; Centers for Disease Control and Prevention, 2011).
Related: Staying Healthy: Why Screening Matters
More Information: Finding Out More About Anal Health