Anal Cancer Risk Factors
Anal cancer has been linked to the human papilloma virus (HPV). There are many types of HPV and some strains have also been associated with genital warts, anal warts, and cervical cancer in women. Per year, there are about 4,000 cases of anal cancer diagnosed and 600 deaths in the United States. Other risk factors include:
- Being over 50 years old
- Having many sexual partners.
- Having receptive anal intercourse
- Presence of anal fistulas (abnormal openings)
- Cigarette smoking
Frequently Asked Questions About Anal Warts
What are anal warts?
Anal warts, also known as condyloma, are growths found on the skin around the anus, in the anal canal, or in the lower rectum. They may first appear as tiny spots or growths and are usually painless. Many people may not be aware they have them. Some are discovered because an individual has felt the growths themselves. Should symptoms occur, the most common are itching, bleeding, and/or anal discharge.
What is the difference between the anus and rectum?
The rectum is the lower part of your large intestine where your body stores stool. The anus is the opening of the rectum through which stool exits out of your body.
What causes anal warts?
Anal warts are caused by the human papilloma virus (HPV), which is usually transmitted through sexual contact but not necessarily through anal intercourse. The same type of warts may occur on the penis, scrotum, vagina or labia. Commonly, it takes one to six months from the time you are exposed to the virus until the wart grows, but it can be longer. During that time the virus remains inactive in the tissues. There are many types of human papilloma virus. Some types cause warts on the hands and feet, others cause genital and anal warts, and still others cause cervical and anal cancer.
What treatments are available?
There are several ways anal warts can be treated, depending on the location, number and size of the warts. If the warts are small and on the skin, they can be treated with caustic medications such as podophyllin or bichloracetic acid, which are solutions applied directly to the warts in your doctor’s office. Cold cautery uses liquid nitrogen to freeze off the warts. Hot cautery uses electrical heat. The area is numbed with local anesthesia before the warts are removed. If there are numerous warts, or if they are inside the anal canal, surgical removal is usually required. This is done as a same-day procedure in a hospital or day surgery center.
Must I have the warts removed?
Yes, because they are likely to continue to grow and spread. In addition, untreated anal warts may raise your risk of getting anal cancer.
Will I have to stay in the hospital when I have them removed?
No. If any type of cautery is used, it can be done in the office in just a few minutes. If surgical removal is necessary, it can be done as an outpatient procedure.
If I have surgery, can I return to work right away?
That depends on the extent of the procedure and how you feel. Some people return to work the next day, but most are fairly uncomfortable for a few days. Pain medication can be prescribed to ease the pain.
Can one treatment solve the problem?
The problem with HPV is that the virus can live undetected in the tissues that were not removed. It may take months before the virus causes more warts. At that time they can be removed in the office. If your warts return right after surgery, you may need to be scheduled for additional surgical procedures, which can be done as outpatient procedures. Is there any follow-up? Yes. You will need to have follow-up visits with your doctor at scheduled intervals. Your doctor may also recommend regular anal Pap smears to detect early precancerous changes.
Is there any way to avoid the warts coming back?
The virus may be alive but inactive in tissue that was not destroyed by cautery or removed by surgery. If the virus is still present, there remains a chance that the warts will recur. Talk to your doctor about how often you should be examined to look for recurrent warts.
To reduce your exposure:
- always use condoms (even if your partner has no signs of anal or genital warts)
- avoid any sexual contact with anyone who has anal or genital warts
- have only one sexual partner
Anyone that you have had sexual contact with (including anyone you had sexual contact with in the six months before your warts first appeared), should be checked by his or her doctor even if they do not have symptoms.
